Margaret A. Williams

Delirium/acute confusional states: evaluation devices in nursing.

Characteristics of instruments developed by nurses for use in evaluating delirium/acute confusional states include relative emphasis on observable behavior and the need to impose low respondent burden. Two instruments that have been most used by nurse researchers are described: The Confusion Rating Scale and the NEECHAM Confusion Scale. The former is based on observable behavior; the latter incorporates vital function and oxygen saturation measurements that may serve as early warning signs of impending delirium.

Posthospital convalescence in older women with hip fracture.

Women who had lived at home before hip fracture repair (N=120, M age=79.9) were interviewed before hospital discharge and at 2, 8, and 14 weeks postdischarge to determine (a) early recovery patterns in function and mood, (b) factors predictive of assistance needed in mobility and perceived mobility compared to prefracture status, (c) problems faced, and (d) advice to others. The mobility pattern was that of a relatively rapid gain until 8 weeks, with a smaller gain from 8 to 14 weeks. Affective mood distress was low except in those going to nursing homes. Somatic mood distress was high, decreasing only gradually. Factors predictive of needed assistance in mobility and of perceived mobility included both those without potential for nursing intervention (age, prefracture mobility, how fell, and type of surgical procedure), and those with the potential for intervention (affective distress, fatigue, and urinary problems). Persistent problems related to limitations in mobility, especially in dressing. Overwhelmingly, subjects advised the need for maintaining a good mental attitude.

A Pilot for Understanding Interdisciplinary Teams in Rehabilitation Practice

&NA; Interdisciplinary teams in rehabilitation are effective for positive patient outcomes. They require skills in team building and interprofessional collaboration. The Institute of Medicine has interdisciplinary teams as one of the five core competencies for healthcare workers. In reviewing the literature on teams, several themes were developed, such as communication, collaboration, understanding of roles, and educational levels of team members. Using these themes, a survey was developed to assess perceptions of teams by rehabilitation nurses, physical therapists, and occupational therapists. Significant findings came from questions on educational levels of team members between nurses and occupational therapists and also within the nursing groups. Open‐ended questions asked about barriers and facilitators for effective teams. We hope that these pilot results will lead to discussions on how to improve interdisciplinary teams and make them more effective for better patient outcomes.