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  • Evaluation of the delirium early monitoring system (DEMS)

    Author(s)
    Rippon, Daniel
    Milisen, Koen
    Detroyer, Elke
    Mukaetova-Ladinska, Elizabeta
    Harrison, Beth
    Schuurmans, Marieke
    Pryor, Claire
    Teodorczuk, Andrew
    Griffith University Author(s)
    Teodorczuk, Andrew
    Year published
    2016
    Metadata
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    Abstract
    Despite awareness of the negative health and financial outcomes of delirium, systems to routinely assess and manage the condition are absent in clinical practice. We report the development and pilot evaluation of a Delirium Early Monitoring System (DEMS), designed to be completed by non-medical staff to influence clinical processes within inpatient settings. Two versions of the DEMS are described based on a modified Confusion Assessment Method (DEMS-CAM) and Delirium Observation Screening Scale (DEMS-DOSS). Methods: Both versions of DEMS were piloted on a 20-bedded Psychogeriatric ward over 6 weeks. Training was administered ...
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    Despite awareness of the negative health and financial outcomes of delirium, systems to routinely assess and manage the condition are absent in clinical practice. We report the development and pilot evaluation of a Delirium Early Monitoring System (DEMS), designed to be completed by non-medical staff to influence clinical processes within inpatient settings. Two versions of the DEMS are described based on a modified Confusion Assessment Method (DEMS-CAM) and Delirium Observation Screening Scale (DEMS-DOSS). Methods: Both versions of DEMS were piloted on a 20-bedded Psychogeriatric ward over 6 weeks. Training was administered to ward staff on the use of each version of the DEMS and data were collected via electronic medical records and completed assessment sheets. The primary outcome was patterns of DEMS use and the secondary outcome was the initiation of delirium management protocols. Data regarding the use of the DEMS DOSS and DEMS CAMS were analyzed using χ 2 tests. Results: Completion rates for the DEMS CAM and DEMS DOSS were 79% and 68%, respectively. Non-medical staff were significantly more likely to use the DEMS-CAM as part of daily practice as opposed to the DEMS-DOSS (p<0.001). However, there was no difference between the use of the DEMS-CAM and DEMS-DOSS in triggering related actions such as documentation of assessment scores in patients’ medical records and implementation of delirium management protocols. Conclusions: This real world evaluation revealed that non-medical staff were able to incorporate delirium monitoring into their practice, on the majority of occasions, as part of their daily working routine. Further research is necessary to determine if the routine use of the DEMS can lead to improved understandings and practice of non-medical staff regarding delirium detection.
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    Journal Title
    International Psychogeriatrics
    Volume
    28
    Issue
    11
    DOI
    https://doi.org/10.1017/S1041610216000983
    Subject
    Biomedical and clinical sciences
    Psychology
    Other psychology not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/123883
    Collection
    • Journal articles

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