Developed by: Brigham and Women’s Hospital, Simmons College
Patient is an 86 year old approximately 48 hours post total hip replacement. She is on a PCA for postoperative pain and has started eating. She had an unwitnessed episode of aspiration. She is now hyperactive, legs over side of bed, trying to get out. She is speaking in a non-sensical but clear voice. She is loud and agitated. There is a sitter at her bedside watching TV, which is loud, and the patient's IV pump is alarming. Her concerned daughters arrive and find the mother's behavior to be very out of the ordinary and they are alarmed. The patient's Primary Nurse is receiving report outside the patient's room from the night nurse.
The intent is for the patient's Primary Nurse to provide calming interventions, reassuring the patient and family, to reduce the external environmental stimuli. The nurse will be expected to assess the patient's mental status, consider possible contributing factors to the patient's behavior and engage the family in both the assessment and calming of the patient.
The goal of this simulated experience is to develop and apply problem-solving, critical thinking and current evidence to the care of a patient experiencing delirium. The participant will:
- Perform a focused patient assessment to determine the presence of delirium.
- Â Implement appropriate nursing interventions for a patient experiencing delirium
- Evaluate the effectiveness of the revised multi-disciplinary plan for a patient experiencing delirium
Nurse of the Future Nursing Competencies©
- Patient-Centered Care
- Teamwork and Collaboration
- Evidence-Based Practice
(You must log in to view/download files)
- Simulation File (.sce) (101 downloads)
- Scenario Planning Worksheet (.pdf)
- Expanded Planning Worksheet (.doc)
- Goals and Objectives (.doc)
- Script: Hyperactive Delirium Scenario Expert (.doc)
- Script: Hyperactive Delirium Enviroment Management (.doc)
- Script: Hyperactive Delirium Immediate Page for Help (.doc)
- Script: Hyperactive Delirium Immediate Page for Help then Recovers (.doc)
- Debriefing Questions (.doc)
- Reference: Delirium part one: Clinical features, risk factors and assessment (.txt)
- Reference: Delirium part two: Nursing management (.txt)
- Reference: Elders Tell Their Stories and Guide Nursing Practice (.txt)
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