Nurse-led change: a statewide multidisciplinary collaboration targeting intensive care unit delirium

For more than a decade, research has demonstrated both the widespread prevalence and negative outcomes associated with intensive care unit delirium. Hospitals are, therefore, being called to institute evidence-based protocols to prevent and manage its occurrence. Integrating evidence-based practice into bedside care can be a challenge. Having information ready and accessible is essential to implementing successful change. The state of Michigan, through the Michigan Health and Hospital Association Keystone Center, has historically gathered evidence and formulated processes to facilitate evidence implementation in statewide intensive care units. Toolkits have been developed to facilitate the spread of information and are used as a starting point for sites. This approach has been proven successful in reduction of ventilator-associated pneumonias and catheter-related blood stream infections, while in partnership with Johns Hopkins University. The purpose of this article is to describe the creation of evidence-based toolkits used to facilitate successful statewide changes in practice using an interprofessional team including nurses, physicians, and pharmacists. The content reflects a step-wise approach to not only engage and educate staff, but also strategies to execute and evaluate the effectiveness.