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Published on: February 27, 2018
Prevention and management of postoperative delirium in adult patients: a best practice implementation project
Juliana Rizzo Gnatta1, Sarha de Oliveira Gonçalves Paes2, Maria Fernanda de Oliveira Faria2
1Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil.
Objective:
To describe the process of implementing evidence-based best practices to improve the prevention and management of Postoperative Delirium in the Post-Anesthesia Care Unit.
Method:
Report on an evidence implementation project applying the JBI based on the audit and feedback process, with a structured approach to identifying and managing barriers in accordance with recommended clinical practices. Medical records, electronic nursing record systems, and staff interviews were used to assess compliance rates.
Results:
In the baseline audit, a zero compliance rate was found in most criteria in relation to the best evidence. Following this phase, interprofessional training was carried out, a validated tool was provided to identify patients at risk of delirium, and changes were made to the electronic nursing records system. In the first follow-up audit, there was an increase in the compliance rate in four of the nine criteria audited. Four criteria achieved 100% compliance in the second follow-up audit.
Conclusion:
Best practices were implemented that contributed to improving the prevention and management of Postoperative Delirium. Subsequent to new training and re-auditing after one year, an increase in adherence to best practices was observed.
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