Delirium Screening and Management in Inpatient Rehabilitation Facilities.
Mooyeon Oh-Park, Peii Chen, Vickie Romel-Nichols and 3 others
PMID 29742533WHAT IT FOUND
Admission 3D-CAM screening in an inpatient rehab facility found delirium in 41 of 399 first admissions.
Patients with brain disorders screened positive more often than orthopedic patients, and those with delirium were transferred back to acute hospitals more often.
Key findings
01A random audit of 424 admissions found that 3D-CAM documentation was almost complete, with only one missing record and eight unscorable results.
02After excluding 16 readmissions and eight unscorable cases, 41 of 399 first admissions were 3D-CAM positive, and patients with brain disorders had a higher positive rate than patients with orthopedic conditions.
03Patients with delirium at admission were transferred back to acute care hospitals more often than patients without delirium, and the report states that transfers were reduced by approximately 30% after implementation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a review and single-institution implementation report, not a randomised trial, so it cannot show that screening or the delirium program improved outcomes. The audit excluded 16 readmissions and eight unscorable cases, so the 399-screened result does not cover all admissions. The report states approximately 30% fewer transfers after implementation, but it gives no control group or detailed before-and-after comparison, so the reduction cannot be attributed to the program. Screening can be unscorable when patients have global aphasia, reduced consciousness, severe agitation, or a language barrier, which limits use in some patients. The paper notes inconsistent outcome findings for delirium subtypes across studies because of different screening methods, classifications, and populations.
Declared interests
No conflicts-of-interest or funding statement is provided in the supplied text. The listed publication types include research support, non-U.S. government.
The easy way to misread this
Do not read the approximately 30% reduction in transfers to acute care hospitals as proof that the delirium program works. The paper reports this as a quality improvement observation without a control group, so it cannot separate the program's effect from other changes.