- Email: [email protected]
Delirium and the Role of the NP
From the College President The mission of the Australian College of Nurse Practitioners is to serve as the national peak organization for nurse practitioners advancing nursing practice and access to health care. Our vision is to: influence health care policy through advocacy, consumer engagement, and research; instill nurse practitioner knowledge, competency, and capability through access to quality education; and facilitate the development of a community of professional practice. The ACNP is governed by an elected board of directors composed of an executive committee and eight state directors, a patron, and two co-opted members.
ACNP National Office PO Box 637 North Sydney, NSW 2059 Australia Phone: +61 2 9016 4349 Fax: +61 2 9954 0666 [email protected] acnp.org.au
Executive Committee President Chris Raftery, RN, NP, MEmergN, MBA(HSM), MNSc(NP), AFCHSM Vice President Grainne Lowe, RN, NP, BN(Hons), Grad Cert (Emerg), MN Secretary Helena Halton, RN, NP, Grad Cert (Emerg.Nurs), Grad Dip Clin.Nurs.Spec.(NP) Treasurer Robin Moon, RN, NP, RMHN, RM, Grad Cert (Mens Hlth), Grad Dip Bus(Mgt), MN(NP), FFACNP Patron Professor Judy Lumby AM, RN, ICU, BA, MHPEd, PhD Co-Opted Member Jane O’Connell, RN, NP, Grad Cert A&E, MN, FFACNP Co-Opted Member Chris Helms, RN, NP, MSN, ANP-BC, FACNP Co-Opted Member Helen Gosby, RN, NP, BA, Grad Dip (Nursing), MN, FFACNP
Board of Directors Australian Capital Territory Kate Maher, RN, NP, Grad Cert (Critical Care Nursing), MN(NP) New South Wales Anne Moehead, RN, NP, RPN, MMH, CMHN, OAM, FACNP Northern Territory Lyn Byers, RN, NP, RM, BSc (Hons), MNP Queensland Lee Poole RN, RM, NP, BH(Nurs), GradCertMgt, GradCert Emergency Nursing, GradDip Midwifery, MNursing, MNPractS South Australia Stuart Smith, RN, NP, DipHEd, BSc (Hons), MSc Tasmania Tammy Harvey, RN, NP, Grad Cert (Emerg), MN
Delirium and the Role of the NP
A
re nurse practitioners (NP) improving outcomes for the older person at risk of delirium? Delirium is an acute disorder of attention and cognition. It is a challenging, often fatal illness, costing more than $164 billion per year in the USA. Delirium occurs across many specialties and settings. It is mostly recognized by nursing staff, and generally it is skilled nursing care that delivers early recovery and reduction in mortality and morbidity. It is proposed that the role of the NP, as the lead clinician in the detection and management of delirium as described by the literature, is well placed to provide thorough delirium screening, prevention, detection, and management. The use of highly developed assessment skills, the ability to prescribe and cease inappropriate medications, and collaborate and consult with the treating team on the medical emergency that delirium can present, consolidates NPs’ powerful role in delirium diagnosis, management, research, and education. They may also have the ability to generate an income stream with accurate diagnosis that can meet the costs of specifically tailored delirium management, particularly in the acute setting. The New South Wales Agency for Clinical Innovation in Australia has 7 key principles for the confused older hospitalised person that provide a platform on which to improve the experience and outcomes for older persons at risk for delirium. As a potent indicator of patient safety, delirium serves as a useful outcome measure to assess quality of care in hospitalised elderly persons and clearly an outcome to be avoided. Considering that as much as 50% of cases may be preventable, the challenge for NPs is to commit to apply advanced nursing skills to avoid delirium for these vulnerable patients. Chris Raftery, National President Guest author: Anne Moehead, National Board Director 1555-4155/15/$ see front matter © 2015 Elsevier, Inc. All rights reserved. http://dx.doi.org/10.1016/j.nurpra.2015.03.001
Victoria Kathleen Tori, RN, NP, MN(NP), MHSc, BHSc, CCRN, GradDip VET, MACN, MACNP Western Australia Alan Noonan, JP, RN, NP, Post Grad Dip (NP)
468
The Journal for Nurse Practitioners - JNP
Volume 11, Issue 4, April 2015
ACNP National Office PO Box 637 North Sydney, NSW 2059 Australia Phone: +61 2 9016 4349 Fax: +61 2 9954 0666 [email protected] acnp.org.au
Executive Committee President Chris Raftery, RN, NP, MEmergN, MBA(HSM), MNSc(NP), AFCHSM Vice President Grainne Lowe, RN, NP, BN(Hons), Grad Cert (Emerg), MN Secretary Helena Halton, RN, NP, Grad Cert (Emerg.Nurs), Grad Dip Clin.Nurs.Spec.(NP) Treasurer Robin Moon, RN, NP, RMHN, RM, Grad Cert (Mens Hlth), Grad Dip Bus(Mgt), MN(NP), FFACNP Patron Professor Judy Lumby AM, RN, ICU, BA, MHPEd, PhD Co-Opted Member Jane O’Connell, RN, NP, Grad Cert A&E, MN, FFACNP Co-Opted Member Chris Helms, RN, NP, MSN, ANP-BC, FACNP Co-Opted Member Helen Gosby, RN, NP, BA, Grad Dip (Nursing), MN, FFACNP
Board of Directors Australian Capital Territory Kate Maher, RN, NP, Grad Cert (Critical Care Nursing), MN(NP) New South Wales Anne Moehead, RN, NP, RPN, MMH, CMHN, OAM, FACNP Northern Territory Lyn Byers, RN, NP, RM, BSc (Hons), MNP Queensland Lee Poole RN, RM, NP, BH(Nurs), GradCertMgt, GradCert Emergency Nursing, GradDip Midwifery, MNursing, MNPractS South Australia Stuart Smith, RN, NP, DipHEd, BSc (Hons), MSc Tasmania Tammy Harvey, RN, NP, Grad Cert (Emerg), MN
Delirium and the Role of the NP
A
re nurse practitioners (NP) improving outcomes for the older person at risk of delirium? Delirium is an acute disorder of attention and cognition. It is a challenging, often fatal illness, costing more than $164 billion per year in the USA. Delirium occurs across many specialties and settings. It is mostly recognized by nursing staff, and generally it is skilled nursing care that delivers early recovery and reduction in mortality and morbidity. It is proposed that the role of the NP, as the lead clinician in the detection and management of delirium as described by the literature, is well placed to provide thorough delirium screening, prevention, detection, and management. The use of highly developed assessment skills, the ability to prescribe and cease inappropriate medications, and collaborate and consult with the treating team on the medical emergency that delirium can present, consolidates NPs’ powerful role in delirium diagnosis, management, research, and education. They may also have the ability to generate an income stream with accurate diagnosis that can meet the costs of specifically tailored delirium management, particularly in the acute setting. The New South Wales Agency for Clinical Innovation in Australia has 7 key principles for the confused older hospitalised person that provide a platform on which to improve the experience and outcomes for older persons at risk for delirium. As a potent indicator of patient safety, delirium serves as a useful outcome measure to assess quality of care in hospitalised elderly persons and clearly an outcome to be avoided. Considering that as much as 50% of cases may be preventable, the challenge for NPs is to commit to apply advanced nursing skills to avoid delirium for these vulnerable patients. Chris Raftery, National President Guest author: Anne Moehead, National Board Director 1555-4155/15/$ see front matter © 2015 Elsevier, Inc. All rights reserved. http://dx.doi.org/10.1016/j.nurpra.2015.03.001
Victoria Kathleen Tori, RN, NP, MN(NP), MHSc, BHSc, CCRN, GradDip VET, MACN, MACNP Western Australia Alan Noonan, JP, RN, NP, Post Grad Dip (NP)
468
The Journal for Nurse Practitioners - JNP
Volume 11, Issue 4, April 2015