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Massachusetts Intensive Care Unit Nurses From Multiple Hospitals Develop a Collaborative to Improve Delirium
Dimensions of Critical Care Nursing : DCCN
|January 31, 2022
Summary
Improving delirium screening accuracy in intensive care units (ICUs) through a collaborative approach led to an 88.3% success rate. This initiative highlights the power of inter-hospital teamwork in enhancing patient care and outcomes.
Area of Science:
- Critical care nursing
- Patient safety
- Quality improvement in healthcare
Background:
- Delirium in intensive care unit (ICU) patients presents significant cognitive, physical, and mental health challenges.
- Unrecognized delirium leads to life-altering consequences for ICU patients.
- A collaborative of Massachusetts ICU nurse leaders was formed to address low delirium screening accuracy across four hospitals.
Purpose of the Study:
- To describe the development of a regional collaborative among ICU nurse leaders.
- To outline a delirium accuracy assessment program implemented across multiple institutions.
- To improve delirium screening accuracy to over 80% in ICU patients.
Main Methods:
- Formation of a regional collaborative in March 2015, involving graduates from the Clinical Scene Investigator Academy and Boston-area ICU nurses.
- Implementation of a delirium accuracy assessment program, scaled to the specific needs of each participating institution.
- Evaluation of program effectiveness using a preaudit-postaudit design.
Main Results:
- Achieved an overall delirium screening accuracy of 88.3% (P < .01).
- Demonstrated a marked improvement in accuracy for patients with an altered Richmond Agitation Sedation Scale score, reaching 87.7% (P < .01).
Conclusions:
- Healthcare quality improvement initiatives are often conducted in isolation.
- Inter-institutional collaboration among critical care nurses can drive significant transformation in healthcare.
- Empowering nurses with knowledge, skills, and collaborative opportunities enhances patient care delivery.
