Posts Tagged "hospital"


Delirium in Hospitals

Delirium in Hospitals


Posted By on Nov 10, 2015

Delirium is harrowing condition characterized by hallucinations and confusion. Delirium sufferers can experience vivid waking nightmares, which can appear without warning and last weeks. Hospital delirium is scary. Hospitalized patients are already in weakened states, and hospitals contain a huge number of hazards for people who are in a confused state.

 

Luckily, medical professionals, families, and journalists have been raising awareness about this strange and nightmarish condition. Several articles have lately pointed to the acute dangers presented by delirium appearing in already hospitalized patients. Medical professionals are still not entirely sure about the causes of or solutions to hospital delirium, but they and the care teams of patients are discussing the big relevant issues and trying to identify solutions.

What is Delirium?

First, delirium is not the same thing as dementia. Delirium can come and come, and it is generally less predictable than dementia. The two can be present together, and ruling out delirium is an important step in identifying dementia. Delirium patients frequently recover fully, so the distinction is an important one.  

 

Delirium is often preventable but is regularly missed or misdiagnosed (research suggests it can be missed in up to half of all cases). Part of the reason delirium is so often missed is because its symptoms can include things present in other conditions. According to the National Institute of Health (NIH), these symptoms can include:

  • hallucinations
  • exhaustion and disrupted sleep  
  • memory loss
  • trouble completing normal tasks like going to the bathroom
  • mood swings

Many of these symptoms will look familiar to anyone who has dealt with dementia. Even trained physicians miss it. Unlike dementia, though, delirium can often be stopped (dementia is usually permanent and degenerative). Delirium is often directly related to medications, and taking a patient off these medications can make the problem vanish.

Why Does Delirium Occur in Hospitals?

Delirium hits hospital patients most often when they’ve been sedated (in fact, some doctors refer to the condition as “ICU psychosis”). The sedatives which medical professionals use to numb patients during highly stressful and invasive operations—ostensibly to keep patients’ emotions safe—appear to be associated with delirium. Additionally, the intense stress that comes with an operation, and the unfamiliar location of the hospital, can put patients at risk of developing the condition.

 

Hospital delirium is a common occurrence, affecting 7 million patients every year, according to an article which ran this summer in the Atlantic. If one of your loved ones is sedated during an operation, monitor her or him for any sign of delirium. Don’t write off strange behavior as simply the normal reaction of an elderly person to stress. Additionally, don’t assume someone who acts strangely around the same time as their surgery is developing dementia. Remember how frequently delirium diagnoses are missed.   

 

Keep an eye on any hospitalized loved ones you suspect may be suffering from delirium. Hospitals are not good places to wander around confused in. Medical equipment can be dangerous when misused. Moreover, hospitals can be cold and frightening to a person suffering from hallucinations and confusion. Stress will not help someone with delirium, and may even prolong the effects.

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The New Jersey Supreme Court recently ruled that a hospital involved in a medical malpractice case did not have to turn over the results of its internal investigation concerning an infant’s brain injury during delivery.

The court’s Sept. 29 decision could potentially impact other medical malpractice cases across the country, including in Indiana.

The baby’s parents demanded access to internal documents spelling out mistakes that were made that led to the baby suffering seizure disorder in May 2007. However, the court upheld the confidentiality claim of Valley Hospital in Ridgewood, N.J.

A trial court judge had previously ruled in favor of the hospital, according to an NJ.com article published Sept. 30, on the basis that the internal memos were protected under a 2004 law known as the Patient Safety Act. The law allows hospital personnel to freely discuss mistakes without fear of recrimination in an effort to prevent errors from recurring.

The parents’ medical malpractice attorneys appealed the trial court judge’s decision. They argued on appeal that the hospital was not protected under the Act because it had not performed its internal investigation in accordance with rules the state health department enacted in 2008.

Valley Hospital argued that it could not be in violation of a rule that wasn’t in effect at the time the 2007 investigation took place. That argument ultimately proved successful.

Supporters of the Act told the website they believed the New Jersey Supreme Court made the right decision. They said the law was never intended to protect doctors and hospitals from liability. Patients and family members are still able to subpoena other types of records, and can also attempt to compel doctors and other professionals who participate in confidential investigations to testify in medical malpractice cases.

Medical Malpractice in Indiana

The Indiana Medical Malpractice Act specifies that a panel of healthcare professionals must review any sort of malpractice claim before it can be filed in court. The panel issues an opinion on whether enough evidence exists to show that either the medical facility or its staff members did not provide the correct standard of care. Once the report is filed, it can be admitted in court but it is not binding.

Indiana’s Hospital Medical Error Reporting Rule states that hospitals are required to implement a process that details the occurrence of several types of “reportable events.” These include surgery performed on the wrong body part or the wrong patient, death or disability due to contaminated drugs or devices, and many others. These reports, according to the rule, “shall be used by the department for purposes of public reporting the type and number of reportable events occurring within each hospital.”

The Indiana Code states that medical staff committee members conducting retrospective reviews are immune from civil liability in regard to their deliberations. (Section 16-21-2-8.) However, confidential records and proceedings “may be produced on court order in a cause in which the records and proceedings are relevant or material.”

It remains to be seen what effect, if any, the New Jersey ruling will have on medical malpractice cases in Indiana and throughout the country.

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