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ABSTRACT: Background
Elderly patients with cognitive impairment are at increased risk of developing delirium, especially in the intensive care unit.Objective
To evaluate the efficacy of a computer-based clinical decision support system that recommends consulting a geriatrician and discontinuing use of urinary catheters, physical restraints, and unnecessary anticholinergic drugs in reducing the incidence of delirium.Methods
Data for a subgroup of patients enrolled in a large clinical trial who were transferred to the intensive care units of a tertiary-care, urban public hospital in Indianapolis were analyzed. Data were collected on frequency of orders for consultation with a geriatrician; discontinuation of urinary catheterization, physical restraints, or anticholinergic drugs; and the incidence of delirium.Results
The sample consisted of 60 adults with cognitive impairment. Mean age was 74.6 years; 45% were African American, and 52% were women. No differences were detected between the intervention and the control groups in orders for consultation with a geriatrician (33% vs 40%; P = .79) or for discontinuation of urinary catheters (72% vs 76%; P = .99), physical restraints (12% vs 0%; P=.47), or anticholinergic drugs (67% vs 36%; P=.37). The 2 groups did not differ in the incidence of delirium (27% vs 29%; P = .85).Conclusion
Use of a computer-based clinical decision support system may not be effective in changing prescribing patterns or in decreasing the incidence of delirium.
SUBMITTER: Khan BA
PROVIDER: S-EPMC3752665 | biostudies-literature | 2013 May
REPOSITORIES: biostudies-literature
Khan Babar A BA Calvo-Ayala Enrique E Campbell Noll N Perkins Anthony A Ionescu Ruxandra R Tricker Jason J Campbell Tiffany T Zawahiri Mohammed M Buckley John D JD Farber Mark O MO Boustani Malaz A MA
American journal of critical care : an official publication, American Association of Critical-Care Nurses 20130501 3
<h4>Background</h4>Elderly patients with cognitive impairment are at increased risk of developing delirium, especially in the intensive care unit.<h4>Objective</h4>To evaluate the efficacy of a computer-based clinical decision support system that recommends consulting a geriatrician and discontinuing use of urinary catheters, physical restraints, and unnecessary anticholinergic drugs in reducing the incidence of delirium.<h4>Methods</h4>Data for a subgroup of patients enrolled in a large clinica ...[more]