Date Available

5-2-2017

Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Martha Biddle

Clinical Mentor

Dr. Tara Blair

Committee Member

Dr. Sheila Melander

Committee Member

Dr. Patricia K. Howard

Abstract

Delirium is an acute, temporary cognitive disorder that is characterized by a change in mental status, altered level of judgement, and changes in perception and behavior. Elderly patients who undergo open cardiac surgery are particularly at risk for developing delirium postoperatively. Although it is a temporary disorder, there are many consequences associated with delirium after cardiac surgery, including a longer length of stay in the hospital, long term functional decline, a greater use of health care resources and an increase in mortality risk. The purpose of this project was to identify the one-year incidence of postoperative delirium after cardiac surgery at the University of Kentucky Medical Center (UKMC). Methods: Retrospective review of medical records of all patients who underwent open cardiac surgery at UKMC to ascertain the incidence of postoperative delirium, and a feasibility study of the use of a 4-point delirium prediction rule in a preoperative clinic setting. Results: Delirium at the UKMC was formally diagnosed at a rate of 0.16% in the fiscal year 2015-2016. This project demonstrates that it is feasible to administer a Delirium Prediction Rule preoperatively with minimal difficulty and little time commitment in an outpatient setting for a cardiac surgery preoperative clinic visit. Conclusions: The use of a Delirium Prediction Rule to stratify risk in the preoperative clinic setting could facilitate targeted prevention and treatment strategies with the goal of reducing negative outcomes associated with the disorder.

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