Acute Confusional State and Management by Healthcare Personnel among Medical Elderly Patients in a Tertiary Care Hospital

• Main Authors: Chulaluk Jaipang, Porntip Malathum, Nuchanad Sutti, Yuttachai Likitjaroen, จุฬาลักษณ์ ใจแปง, พรทิพย์ มาลาธรรม, นุชนาฏ สุทธิ, ยุทธชัย ลิขิตเจริญ
• Other Authors: Mahidol University. Faculty of Medicine Ramathibodi Hospital. Ramathibodi School of Nursing
• Format: Article
• Language: Thai
• Published: 2021
• Subjects: Acute confusional state; Medical elderly patients; Prevalence and Incidence; Management; Healthcare personnel; ภาวะสับสนเฉียบพลัน; ผู้สูงอายุในแผนกอายุรกรรม; ความชุกและอุบัติการณ์; การจัดการ; บุคลากรด้านสุขภาพ
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/62034
• Institution: Mahidol University

Acute confusional state (ACS) is a common condition in hospitalized elderly patients. However, little is known about the prevalence and incidence, and how healthcare personnel manage the ACS in hospitalized elderly patients. This prospective descriptive study aimed to explore the prevalence and incidence of ACS in elderly patients, and management by the healthcare personnel in elderly patients with ACS admitted to medical wards. Purposive sampling was used to recruit a sample of 192 elderly patients in medical wards at a tertiary hospital, and consecutive sampling was used to recruit a sample of 31 healthcare personnel working in those wards. The data collection was conducted from August to November 2018, using questionnaires and assessment forms. The data were analyzed using descriptive statistics, Chi-square, and content analysis. The point prevalence rate of ACS in elderly patients at admission was 3.65%, while its incidence was 5.21%, so the period prevalence rate was 8.85%. Risk factors associated with ACS included dementia, hypoxemia, advanced age, infection, and insomnia. For management by physicians, all elderly participants received medical treatment to minimize risk factors of ACS. The management by other healthcare personnel included participation in the treatment of underlying causes, managing ACS behaviors, prevention of complications, and restoration of functions. In addition, facilitators for management included family participation in patient care, the interdisciplinary team, care management guidelines, and educational training. Barriers to management consisted of workload and inadequate experience or knowledge of the personnel. Findings suggest that healthcare personnel should proactively assess, prevent, and manage ACS in elderly patients to resume normal as soon as possible.