Date of Award

Fall 2018

Document Type

DNP Project Restricted

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Veronica Wilbur, Ph.D., APRN-FNP, CNE, FAANP

Committee Member

Jennifer E. DiMedio, DNP, CRNP

Committee Member

Cheryl D. Schlamb, DNP, CRNP

Abstract

Terminal agitation, also known as terminal delirium, or terminal restlessness, is a condition of distress that occurs in approximately 25% to 85% of terminally ill patients within the last 24 to 48 hours of life.

A retrospective review was performed evaluating the final days of hospice patients on a selected inpatient unit and determine common factors among those patients who displayed evidence of terminal agitation prior to their death. The charts of 177 hospice patients were evaluated for inclusion criteria and assessed for delirium using the Confusion Assessment Method Instrument (CAM). Data collected included terminal diagnosis, history of anxiety, history of dementia, treatment of pain, dyspnea, or constipation; history of substance use or abuse, evidence of Faith, and need of palliative sedation.

Results from the project showed a positive relationship between the factors of treatment for anxiety, history of dementia and substance use/abuse and agitation 24 hours prior to death.

Keywords: terminal agitation, hospice, end of life, terminal restlessness, terminal delirium, agitated delirium, palliative care

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