Benefits of psychiatric consultation-liaison nurse interventions for older hospitalized patients and their nurses.
Characteristics, changes in psychiatric symptoms, and discharge disposition of older hospitalized patients (> or =60 years) with depression or delirium after intervention by a Psychiatric Consultation-Liaison Nurse (PCLN) in an urban teaching hospital were described. A retrospective cohort design was employed using data from 103 clinical consultation records on older patients consecutively evaluated by the PCLN during a 12-month period. The Geriatric Depression Scale and the Confusion Assessment Method were administered by the PCLN at the first patient visit and again to screen-positive patients immediately before discharge. Thirty percent of the patients scored in the range for clinically significant depression and 33% screened positive for delirium at baseline. PCLN interventions for these patients were multifaceted and tailored to individual needs. A paired t-test comparing the change score revealed a significant decrease in depression (p <.001). The proportion of those who screened positive for delirium went from 33% to 0% (p <.001, Chi-square test). Twelve percent of the screen-positive patients for either depression or delirium had improved discharge options than had been predicted at the time of the initial PCLN contact. A two-item consultee questionnaire also revealed benefits for the staff nurses caring for these older patients in three domains. PCLN services may benefit older hospitalized patients referred for depression and delirium and may contribute to positive staff nurse outcomes as well.
Kurlowicz
L H
LH
School of Nursing, University of Pennsylvania, Philadelphia, PA, USA. lenorek@nursing.upenn.edu
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003693:Delirium / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008875:Middle Aged; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing; D011570:Psychiatry; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires