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Date Available

4-28-2020

Year of Publication

2020

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

Faculty

Dr. Melanie Hardin-Pierce

Committee Member

Dr. Angel Coz

Faculty

Dr. Debra Hall

Abstract

PURPOSE: The purpose of this project is to evaluate the implementation of a standardized delirium education program, delirium assessment protocol, and a standardized CAM-ICU reporting method. The goal of the project is to improve nursing delirium knowledge, CAM-ICU documentation compliance, and interdisciplinary discussion of patient’s delirium status during Multidisciplinary Rounds (MDR). This project has four distinct objectives. 1) Implement a standardized delirium assessment and communication protocol within the Lexington VAHCS ICU. 2) Increase the nursing knowledge and self-confidence of assessing ICU delirium, by 50% using a multifaceted educational approach. 3) Achieve a 90% documentation compliance rate for the CAM-ICU delirium screening tool. 4) Increase healthcare provider discussion of CAM-ICU assessment by 50%, through the utilization of the “FASTHUGSBID” and “Brain Road Map” for Interdisciplinary Communication during MDR.

METHODS: This is an evidence-based quality improvement project with a pre- and post-implementation design to determine the impact of delirium education and policy implementation on nursing perception and knowledge. The study also includes a pre and post electronic chart review to evaluate for delirium screening and documentation compliance post project implementation.

RESULTS: Nursing knowledge of delirium and understanding of how to properly screen for delirium using the CAM-ICU increased compared to the pre-education knowledge assessment. The data revealed the nurses showed knowledge improvement in 6 of 11 knowledge assessment questions (pThe post-implementation data also showed the attending physicians’ leading MDR rounds gave the nurses the opportunity to report on their patients using the FASTHUGSBID rounding tool 93% (65/70) (p

CONCLUSION: The findings from this QA/QI project support the implementation of a standardized delirium communication protocol using a multifaceted delirium education approach. As a result of this project’s implementation, nursing knowledge of delirium, CAM-ICU documentation compliance, as well as the interprofessional communication of patient’s delirium status have all improved.

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