Dr. Kristine Josef is a Neurologic Clinical Specialist with experience working in various areas including adult inpatient rehabilitation and acute care. While working in acute care, she was involved in the Early Mobility project in the intensive care unit that resulted in patient decreased length of stay, decreased hospital costs, and increased incidence of patient discharge home vs post-acute facilities. She has given multiple presentations on the topic of delirium. Recently, she co-authored a poster that was presented at the 2017 Combined Sections Meeting in San Antonio, TX that was titled “Delirium in patients with cerebrovascular accident: increasing treatment team awareness.” Her doctorate in physical therapy is from the University of Medicine & Dentistry of New Jersey, which now is Rutgers University. She is a board certified neurologic clinical specialist through the American Board of Physical Therapy Specialties.
In this interview, she discusses: distinguishing delirium from encephalopathy; tools for accurate delirium screening and diagnosis in critically ill patients; the role physical therapy plays in dealing with the problem of patients with delirium from the standpoint of diagnosis and treatment; if anything can be done pre-surgically to prevent the occurrence of delirium; aging and co-morbidities in relation to delirium; the role of family members in changing the course of delirium in a patient; and the advantages and disadvantages of using physical restraints to manage behavioral symptoms of hospitalized patients.