Nurses’ Knowledge of Signs and Symptoms of Delirium Statement of the Problem

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Delirium is defined as an acute reversible alteration of consciousness leading to distorted attention, cognition, and perception (Steis, Shaughessy & Gordon, 2012).  Many factors contribute to the development of delirium in the hospitalized older adult population including medication, surgery, infection, dehydration, or isolation (Fong, Tlubaev & Inouye, 2009).  With early recognition and diagnosis, delirium maybe a potentially reversible condition.  However, misdiagnosis is common in health care institutions where acute and chronically ill patients frequently receive care (Rigney, 2010).  One important contributor to misdiagnose is the difficulty in ascertaining the patients’ baseline cognitive functioning (Meako, Thompson, & Cochrane, 2011).

Each year millions of patients over the age of 65 are admitted to the hospital and face the risk of developing delirium.  Undiagnosed or untreated delirium results in patient deterioration and can cost the health care system millions of dollars secondary to increased length of stay and long-term negative outcomes (Meako, Thompson, & Cochrane, 2011).  Approximately 14% – 24% of patients admitted to hospitals are reported to have delirium on admission and a significant number may present with the signs and symptoms of acute delirium during hospitalization (Steis et al., 2012).  Delirium impacts all strata of patients and affects 15% – 30% of patients in the general care medical institutions.  Additionally, 40% of the patients affected are in post-operative units and as many as 70% of terminally ill patients are affected (Steis et al., 2012).  According to Rice, Bennett, Gomez, Theall, Knight, & Forman (2011), the impact of delirium is difficult to determine since two thirds of cases may go undiagnosed.

Besides posing health challenges to adults/older adults, delirium place substantial financial constraints on the various health care stakeholders (Middle & Mikelancie, 2015).  These increased costs are related to the complications associated with delirium, which may lead to increased hospital length of stay and treatment cost.  In fact in the United States it is estimated that the costs associated with………………………………………………………..

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