Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Harrington, Candace

Committee Member

Kern, Nancy

Author's Keywords

Delirium, critical care


Background: Delirium in MICUs (medical intensive care units) is an acquired and detrimental condition patients often seen in MICU. This condition has a high prevalence and can result in increased risk of death, comorbidities and length of hospital stay. Prevention is critical to avoid an increased risk of mortality.

Aim: The purpose of quality improvement (QI) project was to implement a delirium bundle in a medical intensive care unit (MICU) to reduce delirium by 20% over an 8-week period.

Method: This QI project utilized the IHI rapid cycle quality improvement model, using two cycles of the Plan-Do-Study-Act (PDSA) model to implement the (ABCDEF) A2F delirium bundle. Non-mechanically ventilated patients had 100% chart audits. Two cycles were completed at 4-week intervals using rapid cycle quality improvement measures.

Results: The results of the QI project demonstrated that the use of the A2F bundle and the accurate use of a delirium screening tool decreased the rate of delirium in MICU patients by 40% in 8 weeks.

Implications: Nurses acquired an advanced training in ICU delirium prevention and identification. Healthcare costs will decrease as the number of patients who were diagnosed with ICU delirium decreased. Society will be positively affected as negative consequences of MICU delirium will be diminished.

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