Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Christen Hunt

Committee Member

Dr. Chizimuzo Okoli

Abstract

Pediatric delirium remains a significant cause of morbidity in pediatric critical care resulting in longer lengths of stay and increased healthcare costs that may extend beyond critical illness. Prevalence rates of pediatric delirium in pediatric intensive care settings are 20%. Not all children’s hospitals regularly assess for pediatric delirium. At the time of this project, the assessment of pediatric delirium was not a standard of practice at John Hopkins All Children’s Hospital (JHACH). Examining provider’s experience, knowledge and self-efficacy of pediatric delirium was the primary aim of this project. The secondary aim was to use information obtained through the first aim to develop education on pediatric delirium and the use of an assessment tool for all providers in the pediatric intensive care unit and the cardiovascular intensive care units. Care providers in the pediatric and cardiovascular intensive care units were surveyed. Of the responders, 93% thought they had cared for a patient who was delirious. In regard to ability to distinguish between the three types of delirium, 31% of the respondents indicated they could recognize hypoactive delirium, 32% indicated they could recognize mixed delirium and 64% indicated that they could recognize hyperactive delirium. A summative proficiency score on experience, knowledge, and self-efficacy about pediatric delirium was obtained and 73% of the respondents scored 80% or greater, indicating a baseline proficiency in knowledge about pediatric delirium. These results provide a framework to focus education and awareness of pediatric delirium at JHACH and reinforce the need for a transition in hospital culture. The findings of the study, thus, serve as the first step for changing the culture at JHACH by prioritizing assessment of and strategies to minimize the morbidities associated with pediatric delirium.

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