Le Dlirium
RADAR"Recognizing Acute Delirium As part of your Routine"
1THE TEAMDesignated Principal InvestigatorPhilippe Voyer RN,
Ph.D.Principal InvestigatorNathalie Champoux
M.D.Co-investigatorsJohanne Desrosiers OT, Ph.D., Philippe
Landreville Ph.D., Jane McCusker M.D., DrPH, Johanne Monette M.D.,
M.Sc., Maryse Savoie RN, M.Sc.
2RADARWho: Nurses and nurse auxiliaries.When: During the
distribution of medication, taking into account the patients
behaviour since the last time medication was given.Where:
Medication logTime to complete: 7 secondsClientele targeted:
Elderly patients, with or without dementia.Clinical settings
targeted: Acute care and long-term care settings.3
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On the back of the form5How to answer the three items of
RADAR"When you gave the patient his/her medication,"61- Was the
patient drowsy?Did he/she tend to fall asleep?Did he/she have
trouble staying awake?
72- Did the patient have difficulty following your
instructions?Did he/she take the medication when you gave it to
him/her? Elderly individual The person held out his/her hand.He/she
brought the medication up to his/her mouth.He/she drank the
water.Elderly person with advanced cognitive impairmentHe/she
opened his/her mouth.Did his/her eyes follow your movements and
gestures as you were talking to him/her (made visual contact)?Did
you have to repeat your instructions?
83- Were the persons movements slowed down?Was he/she moving
slowly? Did he/she move slowly when he/she went to sit down, when
walking, or when taking his/her medication?
Tip:Compare the patient to a person of the same age in good
health.
9How to write up your observations in the RADAR tool10
PVPVPVPhilippe Voyer PV11Simulation exercises12Situation 1
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PVPVPVPhilippe Voyer PV14Situation 1The patient has slowed down.
It takes her time to react, but she listens carefully to the
instructions.The nurse does not have to repeat the instruction in
spite of the slowness of movement.15Situation 1: DROWSINESSWhat
exactly is drowsiness?A patient who is sleeping when you come into
the room is not necessarily drowsy
If the patient wakes up easily when you speak to him/her or when
you touch him/her, he/she is not drowsy.
If the patient is fighting to stay awake, or dozes off again,
despite your interactions with him/her, he/she is
drowsy.16Situation 1: DROWSINESSIn this situation, is it motor
function slowdown or drowsiness? Dont try to distinguish between
them: check both of them on the RADAR form.
17Situation 2
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PVPVPVPhilippe Voyer PV19Situation 2The nurse had to tell the
elderly patient several times to take the medication and the glass
of water.20Situation 3
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PVPVPVPhilippe Voyer PV22Situation 3The nurse has to tell the
patient more than once to take her medication and the glass of
water.23Situation 4
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PVPVPVPhilippe Voyer PV25Situation 4The patient is disoriented
in time and has memory problems. However, she is able to take her
medication as soon as the nurse asks her to. The nurse doesnt need
to repeat the instructions.26WINNING strategies27Strategies for
filling out RADAR correctlyMany reasons can explain behaviour, but
RADAR asks you to write down what you observe.Regardless of the
reason for the observed behavior:The patient has such and such a
disease.The patient slept badly.The patient is coming back from a
test.
28Strategies for filling out RADAR correctlyThere are many
distractions when you give medication:Another patient is talking to
you.A colleague just asked you a question.Something falls on the
floor;Medication is handed out in the dining room where its
noisy.Etc.
29Strategies for filling out RADAR correctlyBefore entering the
room, remind yourself of what you have to watch out for. In
particular, do you have to repeat your instructions?
30Strategies for filling out RADAR correctlyObservation is done
mainly during the distribution of medication But, if you have seen
the patient since the last distribution you can take into account
his/her behavior.For instance, if the patient is drowsy at 10 in
the morning, but is no longer drowsy at lunch when you give
medication, you should check "yes" for drowsiness.
31Strategies for filling out RADAR correctlyLast tipeven if: the
behavior is subtle.you have doubts about what you saw.the behavior
has been present for days or weeks.
Please check yes to the particular item of the
RADAR.32ConclusionYour participation in the process to detect
delirium is essential.
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