Delirium Management Quality Improvement Project to Improve Awareness and Screening in a Medical ICU DOI Creative Commons
Hirsh Makhija,

Kyle F Digrande,

Omar Awan

et al.

Nursing Reports, Journal Year: 2024, Volume and Issue: 15(1), P. 6 - 6

Published: Dec. 30, 2024

Background/Objectives: Although delirium is common during critical illness, standard-of-care detection and prevention practices in real-world intensive care unit (ICU) settings remain inconsistent, often due to a lack of provider education. Despite availability for over 20 years validated screening tools such as the Confusion Assessment Method ICU (CAM-ICU), feasible rigorous educational efforts continue be needed address persistent practice gaps. Methods: Spanning an 8-month quality improvement project period, our single-ICU interdisciplinary effort involved delivery CAM-ICU pocket cards bedside nurses, lectures by experienced champions that included live demonstration using CAM-ICU, comprehensive discussion evidence-based strategies (e.g., benzodiazepine avoidance). Subsequent engagement health system leadership motivated development electronic record dataset evaluate unit-level outcomes, including documentation administration. Results: Using spanned 9 pre- 37 post-project months 3612 patients, 4470 admissions, 33,913 patient days, we observed education was followed dramatic rise documentation, from <1% daytime nighttime shifts peaks 73% 71%, respectively (p < 0.0001 trend), fall proportion mechanically ventilated patients ever receiving infusions (69% 41%; p 0.0001). Conclusions: An comprising on can yield significant improvements sedative This approach help ICUs jumpstart build awareness longstanding gaps practices.

Language: Английский

Barriers to nurse-led delirium management in intensive care units: an integrative systematic review using COM-B model DOI Creative Commons

Mokhtar Abdu Almoliky,

Sameer A. Alkubati, Khalil Saleh

et al.

BMC Nursing, Journal Year: 2025, Volume and Issue: 24(1)

Published: Jan. 27, 2025

Language: Английский

Citations

1
Delirium prevalence and management in general wards, emergency departments, rehabilitation centres and nursing homes in Germany, Austria and Switzerland (DACH countries): A secondary analysis of a worldwide point prevalence study DOI Creative Commons
Florian Schimböck, Lars Krüger, Magdalena Hoffmann

et al.

International Journal of Nursing Studies Advances, Journal Year: 2025, Volume and Issue: 8, P. 100309 - 100309

Published: Feb. 10, 2025

Delirium is a common neuropsychiatric syndrome associated with an increased risk of mortality and length stay. Current delirium prevalence, assessments management practices in DACH countries are unknown. To examine the point assessment, general wards, emergency departments, rehabilitation centres nursing homes countries. Secondary data analysis from prospective, cross-sectional, worldwide one-day prevalence study (registered German Registry for Clinical Trials, DRKS00030002). General hospital excluding operating rooms, ambulatory, high acuity, intermediate care intensive units. In total, 172 wards (majority were wards; 91.3 %, n = 157) Germany, Austria Switzerland participated. Descriptive 39-questions online survey aggregated routine patient facility completed by healthcare professionals, administrators, researchers on World Awareness Day, March 15th, 2023. Data collected at 8:00 A.M. P.M. (± 4 h). Use assessments, awareness structures, presence protocols, barriers to structures reported. Overall was 7.1 % (n 143/2,028) 7.2 133/1,842) There no statistically significant difference between assessed valid (p .770) or non-valid assessment .643). The most frequent Nursing Screening Scale (16.3 28/172), Confusion Assessment Method (15.7 27/172) Observation (9.3 16/172). reported interventions provide education "delirium mentioned handovers" (53.5 92/172), "availability experts" (51.2 88/172) during last year" (48.3 83/172). An existing protocol present 76.7 132/172) participating wards. frequently "shortage staff" (45.3 78/172), "patients who difficult assess" (32.6 56/172), "communication gaps professions" (29.1 50/172). As non-pharmacological interventions, "mobilization" (92.4 159/172), "pain management" (87.8 151/172), "adequate fluids" (83.7 144/172) mostly complication patients More than three quarter suggesting published guidelines best practice recommendations. Improved staffing, interprofessional communication could be helpful improve usage addressing management.

Language: Английский

Citations

0
The 2023 World delirium awareness and quality Survey: A Canadian substudy DOI Creative Commons
Karla D. Krewulak, Laurie A. Lee, Kathryn Strayer

et al.

Intensive and Critical Care Nursing, Journal Year: 2025, Volume and Issue: 88, P. 103980 - 103980

Published: March 1, 2025

Language: Английский

Citations

0
Delirium management in 2024: A status check and evolution in clinical practice since 2016 DOI Creative Commons

Oliver Coolens,

Arnold Kaltwasser,

Tobias Melms

et al.

Intensive and Critical Care Nursing, Journal Year: 2025, Volume and Issue: 89, P. 103995 - 103995

Published: March 8, 2025

Delirium in patients on intensive care units (ICU) can lead to prolonged length of stay, cognitive decline and higher mortality. Implementing delirium management is a challenge for healthcare workers. Between 2016 2024, several quality improvement projects were performed German speaking countries. These included founding society, distributing related curricula, awards, surveys, webinars, public materials, others. The aim was assess the current state 2024 identify changes prevention, detection, treatment since 2016. Repetition comparison survey from 2024. Questions items hospital ICU characteristics, present structures, processes, assessment routines, barriers, distributed snowball system Data analysed statistically. Participating both surveys (2016: n = 559, 2024: 447) had similar basic characteristics enabled comparison. Use validated tools slightly increased 56.8 % (n 398) 74.4 438) Significant rates identified use assessments (56.8 vs. 72.8 %), prevention programs (34.6 44.7 information materials families (18.9 33.8 Conversely, there decreased implementation dementia screening (23.7 14.8), restraints (68.3 58.4 top barrier, lack time staff, remained first place. two large indicate cultural shift Open might increase awareness contribute an ongoing change. Improvement addressing barriers delirium-specific are essential improve sustain practices settings.

Language: Английский

Citations

0
Applying an Agile Science Roadmap to Integrate and Evaluate Ethical Frameworks Throughout the Lifecycle and Use of Artificial Intelligence Tools in the Intensive Care Unit DOI
Heidi Lindroth, JUHI SAHAJWANI, Mark Hudson

et al.

Critical Care Nursing Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

0
Delirium prevalence, interventions and barriers in intensive care units in German‐speaking countries: A retrospective cross‐sectional secondary analysis DOI
Matthias Thomas Exl,

Sibylle Fischbacher,

Heidi Lindroth

et al.

Nursing in Critical Care, Journal Year: 2025, Volume and Issue: 30(3)

Published: April 27, 2025

Abstract Background The prevalence of delirium in intensive care units (ICUs) is high and has a major impact on patient outcomes. Aim To describe assessment instruments, prevalence, interventions barriers management adult paediatric ICUs; to explore the association between reported at unit level. Study Design A secondary analysis cross‐sectional World Delirium Awareness Day Survey 15 March 2023. This was prospective study assess one‐day point practices quality improvement efforts across healthcare systems. Data analysed descriptively using multiple linear regression. Results 1612 assessments 123 ICUs from three German‐speaking countries were analysed. most frequently used instrument Intensive Care Screening Checklist (43.9%, n = 54). 8 AM 18.6% PM 20.4% 94 included regression analyses. Prevalence for mixed are comparable. Main over all unit‐level ‘pain management’ (95.9%, 118), ‘mobilization’ (94.3%, 116) ‘verbal re‐orientation’ (84.6%, 104). ‘shortage staff’ (53.7%, 66) ‘patients who difficult assess’ (44.7%, 55). Interventions such as ‘avoidance bladder tubes/catheters’ ICUs, ‘use ear plugs and/or sleep glasses’ associated with reduced prevalence. Across well both ‘lack appropriate scores assessment’ identified significant barrier. Conclusions One fifth assessed ICU patients suffer delirium. Several may have an suggesting approach future studies clinical practice. Relevance Clinical Practice In practice, tubes/catheters’, be prevention treatment interventions.

Language: Английский

Citations

0
Enhancing delirium awareness in South America: current insights and future perspectives for research and practice DOI Creative Commons
Ricardo Kenji Nawa, Thiago Junqueira Avelino‐Silva, Roberta Esteves Vieira de Castro

et al.

Einstein (São Paulo), Journal Year: 2024, Volume and Issue: 22

Published: Jan. 1, 2024

Language: Английский

Citations

0
Letter to the Editor: Commentary on “Delirium in the United States: Results From the 2023 Cross-Sectional World Delirium Awareness Day Prevalence Study” by Lindroth et al (2024) DOI
José Lucas Sena da Silva, Juliana Caldas

Journal of the Academy of Consultation-Liaison Psychiatry, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 1, 2024

Language: Английский

Citations

0
Delirium Management Quality Improvement Project to Improve Awareness and Screening in a Medical ICU DOI Creative Commons
Hirsh Makhija,

Kyle F Digrande,

Omar Awan

et al.

Nursing Reports, Journal Year: 2024, Volume and Issue: 15(1), P. 6 - 6

Published: Dec. 30, 2024

Background/Objectives: Although delirium is common during critical illness, standard-of-care detection and prevention practices in real-world intensive care unit (ICU) settings remain inconsistent, often due to a lack of provider education. Despite availability for over 20 years validated screening tools such as the Confusion Assessment Method ICU (CAM-ICU), feasible rigorous educational efforts continue be needed address persistent practice gaps. Methods: Spanning an 8-month quality improvement project period, our single-ICU interdisciplinary effort involved delivery CAM-ICU pocket cards bedside nurses, lectures by experienced champions that included live demonstration using CAM-ICU, comprehensive discussion evidence-based strategies (e.g., benzodiazepine avoidance). Subsequent engagement health system leadership motivated development electronic record dataset evaluate unit-level outcomes, including documentation administration. Results: Using spanned 9 pre- 37 post-project months 3612 patients, 4470 admissions, 33,913 patient days, we observed education was followed dramatic rise documentation, from <1% daytime nighttime shifts peaks 73% 71%, respectively (p < 0.0001 trend), fall proportion mechanically ventilated patients ever receiving infusions (69% 41%; p 0.0001). Conclusions: An comprising on can yield significant improvements sedative This approach help ICUs jumpstart build awareness longstanding gaps practices.

Language: Английский

Citations

0