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To describe the point prevalence, risk factors and possible outcomes of delirium in inpatients.
A cross-sectional point prevalence study.
Delirium is an acute brain syndrome that negatively affects patients, healthcare professionals and institutions alike; it is common in inpatient settings and is preventable in about one third of cases. Although guidelines recommend systematic screening and assessment, delirium is often unrecognised, undiagnosed and uncoded. There is a lack of valid data on this patient safety indicator in German-speaking countries.
The study was conducted in a tertiary care hospital in Switzerland on 5 July 2022. Specially trained registered nurses collected data from all patients meeting the inclusion criteria using CAM, ICDSC or mCAM-ED. Data were analysed descriptively with stratification by delirium status, setting and surgery.
The point prevalence across all settings was 6.9% (27/390), with large variation between settings: ICU 28.6% (4/14), IMC 28.0% (7/25), wards 4.6% (15/326) and ED 4% (1/25). Surgical patients were almost twice as likely to be affected as medical patients (8.9% vs. 4.8%). Patients with delirium differed most clearly from those without by having a larger number of ICD-10 F-diagnoses, a larger number of medications and higher age, which are known risk factors. Moreover, those with delirium had more missed diagnoses, increased mortality, more adverse events and higher costs.
A significant number of patients experienced delirium and adverse clinical outcomes. Missed delirium diagnoses may further jeopardise patient safety and result in lost revenue. It remains unclear to what extent the risk factors and effects of delirium are causal and what determinants underlie missed diagnoses.
Consistent identification of high-risk patients and treatment settings with elevated risk, accompanied by the implementation of effective preventive and management strategies, is critical to addressing delirium.
Task-shifting from primary care physicians (PCPs) to nurses is one option to better and more efficiently meet the needs of the population in primary care and to overcome PCP shortages. This protocol outlines an overview of systematic reviews to assess the effects of delegation or substitution by nurses of PCPs’ activities regarding clinical, patient-relevant, professional and health services-related outcomes.
We will conduct a systematic literature search for secondary literature in PubMed/MEDLINE, EMBASE, CINAHL and Cochrane databases. Systematic reviews, meta-analyses and Health Technology Assessments in German and English comprising randomised controlled trials and prospective controlled trials will be considered for inclusion. Search terms will include Medical Subject Headings combined with free text words. At least one-third of abstracts and full-text articles are reviewed by two independent reviewers. Methodological quality will be assessed using the Overview Quality Assessment Questionnaire. We will only consider reviews if they include controlled trials, if the profession that substituted or delegated tasks was a nurse, if the profession of the control was a PCP, if the assessed intervention was the same in the intervention and control group and if the Overview Quality Assessment Questionnaire score is ≥5. The corrected covered area will be calculated to describe the degree of overlap of studies in the reviews included in the study. We will report the overview according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
The overview of secondary literature does not require the approval of an Ethics Committee and will be published in a peer-reviewed journal.
CRD42020183327.
by Daniel König, Patrick Jendricke, Katharina Poggel, Lena Staab, Albert Gollhofer
Today, university students face study conditions that increase the risk of sedentary behavior, unhealthy eating, and the likelihood of stress, anxiety, and depression. Although the situation has likely worsened in recent months due to the COVID-19 pandemic, even in the pre-Corona era, several investigations have demonstrated that the students’ health behaviors could increase the incidence of metabolic risk factors and non-communicable diseases, however, further and detailed information is needed to develop tailored counter-strategies. Therefore, in the present survey, the current health status of students at the Albert-Ludwigs-Universität Freiburg (ALU) will be recorded by various questionnaires. In addition, barriers that could potentially influence their health behavior will be identified, and information on the use and awareness of existing health services will be obtained in order to derive concrete needs for further health promotion activities. The study is designed as a monocentric and prospective study at the ALU; the survey of students’ situation and needs assessments will be conducted in the areas of nutrition, exercise, relaxation and stress reduction, self-management, psychosocial health and socio-demographic correlations via an anonymous and self-administered online questionnaire. Subsequently in two-year intervals, the survey will be repeated. Data will be collected over a period of 4 years. One goal of this survey is to gain more insight into the health situation of university students; another goal is to use the knowledge gained to integrate holistic health measures into the university landscape in a structured and sustainable manner. These health measures will be implemented by using the newly developed student health care management at the ALU (www.sgm.uni-freiburg.de). Every two years, after evaluation of the surveys, the effect of the health measures can be checked and adjusted. Trial registration: ETK: 20–1082; DRKS-ID: DRKS00024088.by Ivana Bozicevic, Tatjana Nemeth Blazic, Mirjana Lana Kosanovic Licina, Tatjana Marijan, Tomislav Mestrovic, Tihana De Zan, Aleksandar Stulhofer
To determine the prevalence of genital Chlamydia trachomatis (chlamydia) infection, knowledge about chlamydia and experience of previous testing for chlamydia, we carried out a national probability-based survey in emerging adults aged 18–25 years in Croatia in 2021–2022. Participants (n = 1197), members of a national online panel, completed a web-based questionnaire that collected information on socio-demographics, sexual behaviours and knowledge about sexually transmitted infections (STIs). Urine specimens from a sample of sexually experienced participants were self-collected and tested for chlamydia using Cobas 4800 CT/NG test. To achieve broad representativeness of the emerging adult population in the country, we applied post-hoc weighting for gender and age. Multivariable ordinary least squares linear regression was used to determine correlates of knowledge about chlamydia infection and binomial logistic regression to assess correlates of the willingness to test for chlamydia. Among 448 participants who sent in their urine specimens chlamydia prevalence was 2.5% (95% CI 1.2–5.1) in women and 1.0% (0.3–3.2%) in men. A total of 8.0% of women and 4.7% men reported testing for chlamydia prior to the survey. About a quarter of the sample was characterized by not answering correctly any of the six questions related to knowledge about chlamydia, while only 9.6% had five or six correct answers. In the multivariable analysis, significantly higher odds of willingness to test for chlamydia were found in females compared to males (OR = 1.34, p = 0.024), those with better knowledge about the infection (OR = 1.11, p = 0.005), and those with lower religiosity (OR = 0.91, p = 0.017). In conclusion, prevalence of chlamydia in emerging adults in Croatia is considerable. Efforts to control this infection should focus on primary prevention and targeted testing combined with effective case management strategies.
FreshRSS 