Implementation of an Intensive Care Unit Delirium Protocol: An Interdisciplinary Quality Improvement Project.

Area of Science:

• Critical Care Medicine
• Nursing Education
• Patient Safety

Background:

• Delirium in intensive care units (ICUs) is linked to adverse outcomes, including mortality and long-term disability.
• Nurses play a crucial role in preventing and managing delirium but may lack awareness of current guidelines.
• Educational interventions can enhance nurses' knowledge, confidence, and skills in delirium care.

Purpose of the Study:

• To develop, implement, and evaluate a nursing education program focused on delirium prevention and management in adult ICUs.
• To improve critical-care nurses' familiarity, comfort, and compliance with standardized delirium screening and intervention protocols.

Main Methods:

• A didactic training program was delivered to bedside critical-care nurses.
• A daily bedside delirium screening and care bundle protocol was implemented across all ICUs.
• Pre- and post-educational assessments measured nursing attitudes, confidence, and knowledge regarding delirium care.

Main Results:

• 49 nurses participated, showing significant increases in positive attitudes and confidence (P < .0001).
• Mean knowledge scores improved from 70% to 95% (P < .0001) post-education.
• Compliance with daily screenings and interventions was 56.3%; 20.4% of screenings were positive for delirium.

Conclusions:

• Formal didactic training effectively increases ICU nurses' awareness and knowledge of delirium.
• The program prepares nurses for delirium screening and treatment, despite moderate compliance rates.
• Patients receiving interventions were treated uniformly, indicating consistent application of the care bundle.