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American Delirium Society April 2019 BiMonthly Newsletter

2019 Annual ADS Conference

Registration and Hotel Reservations are now open for the 2019 Annual Meeting of the American Delirium Society being held June 16-18, 2019 at the Boston Park Plaza Hotel in Boston, MA.

This 3-day conference, expected to draw more than 400 investigators, educators, and clinicians from all spectrums of healthcare, is truly the destination for professionals dedicated to delirium care at every level of their career.

The ADS conference is all about learning, networking, and making connections. The diverse group of attendees, across many disciplines and countries, are each dedicated to make a difference in patients across all care settings who are at risk for delirium or who develop delirium.

Our 2019 annual meeting is larger than ever with more than 25 symposia and workshops, 10 oral abstract sessions, a large poster session and a robust all-day Pre-Conference. More than 100 internationally-recognized, faculty will deliver cutting edge clinical and research presentations encompassing all aspects of delirium care. We are proud to say that at ADS 2019 there will be something for everyone!

We look forward to seeing you in Boston this June!

John Devlin, PharmD

ADS President and Boston 2019 Annual Meeting Co-Chair

Babar Khan, MD, MS

ADS President-Elect and Boston 2019 Annual Meeting Co-Chair

Delirium Patient Advocate: Audrey Curtis

Audrey was admitted to St Vincent’s Hospital, Melbourne on 29th March 2017 for aortic valve replacement surgery after several years of cardiac symptoms. Following this surgery, Audrey experienced several episodes of delirium on the ward postoperatively which have had a long-lasting impact on her. She is committed to helping avoid this complication for future patients as she shares in the Patient Safety Movement video linked above.

Ms. Curtis recently shared with ADS, "Being able to talk about delirium with people who understood what I was saying gave me back my confidence and my life as I knew it."

Delirium Professional Advocate: Michael A.E. Ramsay, MD, FRCA

Michael A.E. Ramsay, MD, FRCA, Chairman Department of Anesthesiology Baylor University Medical Center and President of Baylor Research Institute

Dr. Ramsay has just been appointed as chair of the board of the Patient Safety Movement Foundation for 2020 (www.patientsafetymovement.org ). The alarming statistic that 200,000 Americans were dying from preventable causes in our hospitals caused the movement to be founded. The mission is to engage everyone involved in the care of the patient together and develop strategies to reduce these unnecessary deaths to zero.

At this year’s Patient Safety Summit, Dr. Ramsay moderated an international panel on post-operative delirium. The panel concluded that there needs to be a hospital–wide education initiative to increase awareness and screening for post-operative delirium. Prevention and management techniques need to be developed and implemented and families made aware of this potential complication.

The American Delirium Society recently had the opportunity to interview Dr. Ramsay.

ADS: How did you first become involved with delirium care?

Dr. Ramsay: I developed the first Sedation Scale for ICUs – The Ramsay Sedation Score – as a means to control sedative drug administration and keep patients cognitive wherever possible. Otherwise ICU patients would be comatosed when on ventilators and frequently were delirious or cognitively injured when the sedation was stopped. Potentially many causes but the over-sedation might have been one and if we controlled it we could perhaps protect the brain.

ADS: What are your hopes for the role the Patient Safety Movement Foundation will take in 2020 to address delirium?

Dr. Ramsay: 1. Develop a hospital wide education program to increase awareness and the importance of identifying delirium. 2. Learn what strategies can be used to support and best manage such patients. 3. Screen for delirium postoperatively in the recovery room.4. Create awareness of hyperactive, hypoactive and mixed presentations. 5. Make sure that older patients and families are informed about the risks of delirium. 6. Develop guidelines to mitigate the risk of postoperative delirium, such as avoiding the use of benzodiazepine drugs in the elderly. 7. Minimize restraints or antipsychotic medications.

World Delirium Awareness Day: 2019

The International Federation of Delirium Societies (iDelirium) hosted the 3rd annual World Delirium Awareness Day campaign on March 13th. This year #deliriumsuperheros came together on Twitter/Instagram/Facebook and Linkedin to spread the word and share their successes. Go to: www.idelirium.org to take the Delirium Superhero Quiz!

The 2019 campaign included efforts on 6 continents to promote delirium awareness. The iDelirium federation of the American Delirium Society, the Australasian Delirium Association, and the European Delirium Association were critical to mobilizing their membership to increase delirium awareness.

Actions to continue taking throughout the year:

  • Commit to using the term 'delirium'
  • Screen your patients for delirium
  • Listen to patient and family stories about the experience of delirium
  • Engage your leadership in a discussion of Delirium
  • Educate health professionals about delirium

What did you do for WDAD?

Share on Twitter: @iDelirium_Aware

E-mail Stories/Photos to: iDelirium.ifds@gmail.com

Bedside Avatars to Mitigate Delirium: Hospitals Sought to Join Multi-Center NIH-Funded Clinical Study

Clinical research leaders who work with hospitalized elders are sought to join an ongoing NIH-funded clinical study, “care.coach Avatars for Improvement of Outcomes in Hospitalized Elders, Including Mitigation of Falls and Delirium: a Multi-Site Clinical Study”.

Funded by the NIH’s National Institute of Nursing Research (NINR) as part of Small Business Innovation Research (SBIR) project NR017842 awarded to care.coach of Millbrae, CA, the 2-year, randomized controlled clinical study is led by Pace University and Jamaica Hospital Medical Center in New York, NY, with participation from Palmetto Health in Richland, SC, and up to three additional hospitals.

Each care.coach avatar is displayed as a virtual dog or cat on a dedicated tablet device, as shown in Figure 1. Each avatar is remotely controlled by a 24x7 team of health advocates (HAs), who use a specialized work interface to monitor 12 or more patients sequentially (up to 2 simultaneously) through the audio/visual feeds from the patients’ avatar devices, and who communicate with each patient by sending text commands to be spoken in real-time by the avatar. The HAs therefore contribute to the avatar their human abilities for speech understanding and for sociable, compassionate conversational responses to help patients build personal relationships with the avatar. Software embedded into the HA work interface uses branching logic and pre-scripted conversational content to guide HAs through evidence-based intervention protocols, for example by executing cognitive engagement/assessment, re-orientation, toileting checks, and so on, and alerting the nurse station on the hospital unit of any issues potentially requiring action.

A 95-patient pilot study with care.coach avatars at the bedside of intervention group patients found that the avatars significantly mitigated delirium and reduced rate of falls by over 80%, while significantly reducing patient-reported loneliness, compared to the control group who received daily social check-ins from research assistants (www.iproc.org/2018/2/e11883 and https://preprints.jmir.org/preprint/13440). These outcomes were achieved with a simplistic set of protocols based on orientation, reminders about bed exercises, and elicitation of patient needs, in addition to free-form psychosocial support.

The present study aims in 2 years to enroll over 3,000 intervention group patients across all sites, and benefits from additional development funded by NINR, including a comprehensive analysis of the Hospital Elder Life Program (HELP) and systematic implementation of equivalent protocols for execution via avatar. Technology development to be conducted during the study includes machine learning systems for individualization of protocols to maximize patient engagement and outcomes, and automatic screening of delirium through the identification of attentional decline and fluctuating course as inferred by analysis of patient responses to avatar prompts.

An overview of the avatar technology will be presented at the ADS 2019 conference in Boston, and preliminary clinical results will be presented by Profs. Sharon Wexler and Lin Drury of Pace University.

Researchers who work with a suitable inpatient population at risk for falls and delirium are requested to indicate interest in joining the study by emailing the PI at victorwang@alum.mit.edu or by filling out the short form at http://care.coach/NINR-study before May 31, 2019.

Free ADS Membership, When you bring in 3!

ADS would like to enlarge this vital community by providing you with a free annual ADS membership, when you refer three people to join the American Delirium Society. Once three people have completed their membership application and have noted you referred them, our office will contact you about your one free year of membership.

American Delirium Society Listserv

ADS is excited to announce a members only listserv. This is a communication tool which allows the sharing of information, whether you have a question to ask, or a pearl to share. The listserv will facilitate connections between members and expand our knowledge on issues and resources related to delirium. It will archive discussions or information for future retrieval.

1. Open your email and put the list serve email address in the “TO” field. The list serve email is: ads@mailman.americandeliriumsociety.org

2. Type the subject of your message in the subject line.

3. Place the message inside the body of the email and be sure to include contact information.

Examples of how a member might use the listserv include the following:

Pose a question about a specific clinical topic: electronic cognitive screening programs. “Is anyone using an electronic cognitive screening program to assess for delirium in hospitalized patients? Was it difficult to get IT approval?”

Inform others of a new publication that might be of interest to many: Delirium Prevention Using Pet Therapy. (post the url address/link- not the actual article)

Share information regarding an upcoming educational event that might be of interest to others (conferences or webinars). Seek permission for ADS communications chair for events sponsored by organizations other than ADS

Respond to another member’s question

Share an evidence based clinical pearl

Seek input from others on a program or project you are working on.

Comment on a public announcement that involved delirium

Search prior discussions on a topic you currently need more information on.

Invitation to be a part of the ADS Communications and Membership Committee!

The Communications and Membership Committee is responsible for developing venues for ADS to get its messages out and get members involved! This committee ensures that timely and regular communications are maintained on the ADS website and through social media and develops informational materials to be used for information and marketing of the Society. This Committee has responsibility to devise, implement and evaluate a plan for recruitment and retention of members and oversees the Special Interest Groups. To learn more contact the Board Liaison: Marianne Shaughnessy: marianneshaughnessy2@gmail.com

Join the ADS Education Committee!

The committee is currently working on how to both increase the value of membership in ADS and to enhance the access to quality education for the delirium community. To learn more contact the Board Liaison: Christine Waszyinski: Christine.Waszynski@hhchealth.org

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Liz Archambault
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Created with images by geralt - "face faces dialogue" • rawpixel - "man woman group" • MARVIN TOLENTINO - "untitled image"

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