Interdisciplinary Collaborative Strategies to Improve Delirium Screening Documentation in the Pediatric CICU

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Quality improvement initiatives

Background:

• Consistent delirium screening and documentation remain challenging in pediatric intensive care units.
• Current practices often lack standardization, leading to low compliance rates.
• Delirium in critically ill children can impact outcomes and requires vigilant monitoring.

Purpose of the Study:

• To enhance delirium screening and documentation rates in a pediatric cardiac intensive care unit (CICU).
• The goal was to increase compliance from 10% to 85% within 12 months.
• To establish a sustainable, multi-disciplinary approach to delirium management.

Main Methods:

• A review of electronic health records identified barriers to delirium screening.
• Interventions included updating electronic order-sets and flowsheets for standardized screening.
• Unit-wide nursing education utilized the Cornell Assessment of Pediatric Delirium tool.

Main Results:

• Initial screening and documentation compliance was only 10%.
• Following the intervention, compliance reached 97% within one year.
• The strategy proved highly effective in improving adherence to delirium screening protocols.

Conclusions:

• A multi-disciplinary strategy integrating standardized electronic tools and education significantly improved delirium screening.
• The pediatric cardiac intensive care unit achieved substantial gains in documentation compliance.
• This approach offers a model for enhancing delirium care in similar settings.