Journal of Gerontological Nursing

Feature Article 

Delirium in Older Cardiac Surgery Patients: Directions for Practice

Sean P. Clarke, PhD, RN, FAAN; Marion E. McRae, MScN, RN, ACNP-BC, CCRN-CSC-CMC, CCN(C); Sandra Del Signore, MN, RN, NP, CCN(C); Maria Schubert, PhD, RN; Rima Styra, MD, MEd, FRCPC

Abstract

Delirium affects approximately 20% to 25% of patients undergoing cardiac surgery and is particularly common in older adults. This article reviews the etiology and risk factors for delirium associated with cardiac surgery in older adults. Delirium screening, prevention, and treatment strategies, including both pharmacological and nonpharamcological therapies, are presented. Interventions appropriate in both the intensive care unit and ward settings after cardiac surgery are outlined.

Abstract

Delirium affects approximately 20% to 25% of patients undergoing cardiac surgery and is particularly common in older adults. This article reviews the etiology and risk factors for delirium associated with cardiac surgery in older adults. Delirium screening, prevention, and treatment strategies, including both pharmacological and nonpharamcological therapies, are presented. Interventions appropriate in both the intensive care unit and ward settings after cardiac surgery are outlined.

Dr. Clarke is RBC Chair in Cardiovascular Nursing Research, Peter Munk Cardiac Centre (PMCC), Toronto General Hospital site, University Health Network and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; Ms. McRae is Nurse Practitioner-Cardiovascular Surgery, PMCC, and Adjunct Clinical Faculty at the Bloomberg Faculty. At the time this article was written, Ms. Del Signore was Nurse Practitioner-Cardiovascular Surgery at PMCC, and Dr. Schubert was a postdoctoral fellow at the Bloomberg Faculty. Dr. Styra is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.

Address correspondence to Sean Patrick Clarke, PhD, RN, FAAN, RBC Chair in Cardiovascular Nursing Research, Peter Munk Cardiac Centre, University Health Network, and Associate Professor, University of Toronto, 200 Elizabeth Street, Room 4NU492, Toronto, Ontario, Canada M5G 2C4; e-mail: sean.clarke@uhn.on.ca.

Received: March 05, 2010
Accepted: July 26, 2010

Posted Online: October 22, 2010

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Authors

Dr. Clarke is RBC Chair in Cardiovascular Nursing Research, Peter Munk Cardiac Centre (PMCC), Toronto General Hospital site, University Health Network and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; Ms. McRae is Nurse Practitioner-Cardiovascular Surgery, PMCC, and Adjunct Clinical Faculty at the Bloomberg Faculty. At the time this article was written, Ms. Del Signore was Nurse Practitioner-Cardiovascular Surgery at PMCC, and Dr. Schubert was a postdoctoral fellow at the Bloomberg Faculty. Dr. Styra is Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.

Address correspondence to Sean Patrick Clarke, PhD, RN, FAAN, RBC Chair in Cardiovascular Nursing Research, Peter Munk Cardiac Centre, University Health Network, and Associate Professor, University of Toronto, 200 Elizabeth Street, Room 4NU492, Toronto, Ontario, Canada M5G 2C4; e-mail: .sean.clarke@uhn.on.ca

10.3928/00989134-20100930-05

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