CHAMPIncident Delirium in theHospitalized Senior课件.ppt

CHAMPIncident Delirium in the Hospitalized Senior;Goals;ObjectivesSection 1 (Don);ObjectivesSection 2 (Andrea);HPI: Mrs. G., 87 y.o. woman from home; 4-5 days c fever, cough, malaise, ?appetite, ?po; 1 day ? DOE PHx: DM c neuropathy, HTN, A-Fib, OA, Glaucoma, COPD Meds: glipizide, amitriptyline qhs, lisinopril, Digoxin, Vioxx, T#3’s prn, Warfarin, Ditropan Soc / Fx Hx: Lives with husband, retired teacher, Ind. in ADLs and IADL’s PEx Vitals 381; 155/90,HR 105, RR 20; O2 94% RA, Non-Toxic HEENT: edentulous, dry OP Chest: ? BS and Exp Wheezes CV: Syst. M c/w SEM Abd: Benign; g- Ext’s: Trace Pedal Edema Neuro: AO X 3, Non-Lateralizing, follows commands ; U/A: 20 WBC, +LE / N, Many Bacteria U Bld Cx’s P CXR: + COPD Changes / ?RLL Infiltrate ECG: A-Fib @ 105 ;Teaching about Delirium in Hospitalized Seniors;Teaching Moment Alert!;Delirium in Hospitalized Seniors: Significance;Delirium in Hospitalized Seniors: Significance;Learn More Teach More About Assessing Baseline Risk for Delirium;The Past: Patient-Specific Risk Factors from Prospective Studies;Sharon Inouye’s Work;Delirium:Multifactorial Model;Predicting Delirium:PreDisposing Risk Factors;Predicting Delirium:PreDisposing Risk Factors;Teachable Moment ALERT !;Teachable Moment ALERT !;Learn More Teach More About Diagnosing Delirium: Using the Confusion Assessment Method (CAM) ;Delirium: Diagnosis--CAM;CAM (Confusion Assessment Method);Validity of CAM;Underdetection of Delirium;Common Errors in Recognition;Distinguishing Delirium from Dementia(See Pocket Card);To Diagnose Delirium As a Springboard To Help Distinguish Delirium from Dementia (see Pocket Card) BEDSIDE TEACHING TRIGGERS Suspected Delirious Patient, Dementia Patient DEMONSTRATE USE OF CAM TO DIAGNOSE HYPOACTIVE DELIRIUM OR USE OF CAM TO DIAGNOSE AND DISTINGUISH HYPOACTIVE DELIRIUM VS. DEMENTIA (see Pocket Card) ;Video Clip Practice