Date on Paper

7-2020

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Harrington, Candace

Committee Member

Roser, Lynn

Author's Keywords

Medical-surgical; delirium assessment; delirium education; delirium-screening scale; delirium compliance; older adults

Abstract

Background: Delirium is an acute, reversible syndrome that may cause cognitive impairment, disorientation, perceptual disturbances, attention discrepancies, and fluctuating psychomotor activities. Health professionals may not recognize, treat, or prevent delirium. More than seven million hospitalized adults, with an estimated cost of $164 billion annually, suffer from delirium each year. Consequently, delirium commonly affects 15 to 37% of the older adult population, yet less than 5% of delirium cases are documented in the electronic medical records of older adult patients. Early detection, intervention, and compliance with best practices are critical for the reduction of hospitalized delirium incidence. Aim: This project aimed to implement an evidence-based delirium prevention bundle in an acute trauma/surgical unit. Short-term goal: To have 50% compliance with all components of the delirium prevention bundle following the implementation of an IHI model practice improvement. Long-term goal: Reduce the incidence of delirium by improving early recognition in an acute care trauma/surgical unit by 30% within one year. Methods: The Institute for Healthcare Improvement’s rapid cycle quality improvement model was used for this project. The scope of this project entailed two Plan-Do-Study-Act (PDSA) cycles with recommendations to incorporate primary, secondary, and tertiary prevention measures for delirium. Results: The results of this project showed that the potential effectiveness of the delirium prevention bundle with an aggregate positive change rate of 6.4 % in the first three weeks of the program.

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