2016 Volume 28 Issue 3 Pages 249-256
Delirium is a common psychiatric complication in patients with cancer. Delirium causes marked distress in the patient and his/her family and causes difficulties in cancer treatment and patient care. Some recent studies demonstrated the effectiveness of systematic multicomponent interventions to prevent delirium. We examined a systematic care program for delirium in inpatients. In our program, the nursing staff assessed the risk and occurrence of delirium, and provided early preventive care for delirium. In this study, we retrospectively investigated the operation of our delirium care program, which was administered to inpatients with cancer. About a quarter of the patients had some risk of delirium, and therefore, early preventive care was provided. After this program began, the medical staff was able to care for patients at risk for delirium in a more proactive and precise manner. On the other hand, we compared the delirium assessments conducted by nurses in this program with the diagnoses made following psychiatric consultations. More than half of the patients who were diagnosed with delirium by a psychiatrist were not diagnosed as having delirium by the nurses. Hypoactive and mixed-type delirium were missed more often than the hyperactive type. We must review the nursing staff education program and improve the accuracy of delirium assessment according to the appropriate frequency of delirium assessment to ensure proper diagnosis of delirium.
