Click here to run a PubMed search on use of companions (or playthings) in patients with dementia. There appears to be minimal research on this topic at this point.
The AACN Procedure Manual for Critical Care, 6th ed., 2011, states that although surgically created AV fistulas had been used in the past for CRRT, they are not recommended for CRRT access because of increased rates of injury, bleeding and infection (p. 1023), and the manual references National Kidney Foundation: KDOQI clinical practice guidelines for vascular access: update 2006, Am J Kidney Dis. 2006; 48:S176-S307.
The manual also references Uchino S, et al. Continuous renal replacement therapy: a worldwide practice survey. Intensive Care Med. 2007;33:1563-70.
Of a cohort of 1006 ICU patients treated with CRRT at 54 ICUs in 23 countries, Table 2 (p. 1566) shows that only 1 patient (0.1%) had continuous arteriovenous hemodialysis as the mode for RCCT.
A search of PubMed for continuous renal replacement therapy and access did not identify any studies published in the United States that specifically described using AVF for the access.
Bottom line: There are no published experimental studies evaluating the effect of screening inpatients for delirium on the hospital length of stay.
Summary:
Length of stay: A search of Joanna Briggs and of PubMed and CINAHL using combinations of these concepts–delirium, inpatients, screening, length of stay, outcomes–did not identify any studies of the impact of screening for delirium on length of stay. There were observational studies documenting that delirium in the hospital is associated with increased length of stay. See Han (2011), Saravay (2004) and reviews in the PubMed search. None of these report on effect of screening on length of stay.
Delirium Screening and Assessment. In: Joanna Briggs JBIConnect
PubMed: delirium[mesh] AND (inpatients OR hospitalized patients) AND screening AND length of stay
Clinical outcomes: None of the papers identifed in the searches describe studies assessing effect of screening for delirium on other clinical outcomes, such as mortality or readmission. Again, there are observational studies documenting the effect of delirium on these outcomes, i.e., Uthamalingam (2011), Gonzalez (2009) in the search below.
PubMed: (“delirium/diagnosis”[mesh] OR “delirium/prevention and control”[mesh]) AND (inpatients OR hospitalized patients) AND screening AND (outcomes OR mortality OR readmission)
A search of CINAHL on the concepts of patient and nursing satisfaction and grouping assignment produced these results on care assignments and satisfaction of nurses and patients.
Duffield, Christine. Staffing, skill mix and the model of care. Journal of clinical nursing 2010 vol:19 iss:15-16 pg:2242 -2251
Hurst, Keith. UK ward design: patient dependency, nursing workload, staffing and quality-an observational study. International journal of nursing studies 2008 vol:45 iss:3 pg:370 -381
Adams, Ann, Staffing in acute hospital wards: part 1. The relationship between number of nurses and ward organizational environment. Journal of nursing management 2003 vol:11 iss:5 pg:287 -292
Mohamed, A H, Using the job characteristics model to compare patient care assignment methods of nurses. Eastern Mediterranean health journal 2004 vol:10 iss:3 pg:389 -405
Evidence Matters 