• Improving palliative care.

      Moran, Sue; Milford Nursing Home, Limerick. (2009-05)
      Any service improvement project requires planning, action and evaluation. Using a recognised quality improvement framework can offer a structured approach to implementing and assessing changes to patient care. This article describes how use of the Deming Cycle has helped to identify nurses' learning needs.
    • Phenomenological and neuropsychological profile across motor variants of delirium in a palliative care unit

      Leonard, Maeve; Donnelly, Sinead; Conroy, Marion; Trzepacz, Paula; Meagher, David J; Dept of Adult Psychiatry, Midwestern Regional Hospital, Limerick; Milford Care Centre, Milford, Limerick; Lilly Research Laboratories, Indianapolis, IN, USA. (2011)
      Studies using composite measurement of cognition suggest that cognitive performance is similar across motor variants of delirium. The authors assessed neuropsychological and symptom profiles in 100 consecutive cases of DSM-IV delirium allocated to motor subtypes in a palliative-care unit: Hypoactive (N=33), Hyperactive (N=18), Mixed (N=26), and No-Alteration motor groups (N=23). The Mixed group had more severe delirium, with highest scores for DRS-R-98 sleep-wake cycle disturbance, hallucinations, delusions, and language abnormalities. Neither the total Cognitive Test for Delirium nor its five neuropsychological domains differed across Hyperactive, Mixed, and Hypoactive motor groups. Most patients (70%) with no motor alteration had DRS-R-98 scores in the mild or subsyndromal range even though they met DSM-IV criteria. Motor variants in delirium have similar cognitive profiles, but mixed cases differ in expression of several noncognitive features.