Computerized decision support for delirium superimposed on dementia in older adults

Delirium is common, deadly, and costly in people with dementia. The purpose of this pilot study was to test the feasibility of the computerized decision support component of an intervention strategy-Early Nurse Detection of Delirium Superimposed on Dementia-designed to improve nurse assessment and detection of delirium superimposed on dementia. This pilot study enrolled and followed 15 individuals with dementia (mean age = 83, mean admission Mini-Mental State Examination score = 14.8) and their caregivers daily for the duration of their hospitalization. Results indicated 100% adherence by nursing staff on the delirium assessment decision support screens and 75% adherence on the management screens. Despite the prevalence and severity of delirium in people with dementia, there are currently no published reports of the use of the electronic medical record in delirium detection and management. Success of this effort may encourage similar use of information technology in other settings.