Documentation of acute change in mental status in nursing homes highlights opportunity to augment infection surveillance criteria

Abstract Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections. The use of a possible ACMS definition should be considered for retrospective nursing home infection surveillance.

[1]  R. Lynfield,et al.  Epidemiology of Antibiotic Use for Urinary Tract Infection in Nursing Home Residents. , 2019, Journal of the American Medical Directors Association.

[2]  A. Ciampi,et al.  Nursing Documentation in Long-Term Care Settings , 2014, Clinical nursing research.

[3]  E. Marcantonio,et al.  A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium , 2014, Journal of the American Geriatrics Society.

[4]  Philip Smith,et al.  Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria , 2012, Infection Control & Hospital Epidemiology.

[5]  A. Ciampi,et al.  Detection of delirium and its symptoms by nurses working in a long term care facility. , 2012, Journal of the American Medical Directors Association.

[6]  S. Inouye,et al.  The Confusion Assessment Method: A Systematic Review of Current Usage , 2008, Journal of the American Geriatrics Society.

[7]  S. Inouye.  Delirium in older persons. , 2006, The New England journal of medicine.

[8]  Ying Zhang,et al.  A Chart‐Based Method for Identification of Delirium: Validation Compared with Interviewer Ratings Using the Confusion Assessment Method , 2005, Journal of the American Geriatrics Society.

[9]  E. Marcantonio,et al.  Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[10]  L C Mion,et al.  Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. , 2001, Archives of internal medicine.

[11]  S K Inouye,et al.  Clarifying confusion: the confusion assessment method. A new method for detection of delirium. , 1990, Annals of internal medicine.