Implementation of an Intensive Care Unit Delirium Protocol

作者：Jessica M. Marino, Donald H. Bucher, Michael Beach, Balaji Yegneswaran, Brad Cooper · 发表于：Dimensions of Critical Care Nursing · 年份：2015 · DOI：10.1097/dcc.0000000000000130 · 被引用次数：35 · 研究领域：Intensive Care Unit Cognitive Disorders、Nosocomial Infections in ICU、Sepsis Diagnosis and Treatment

BACKGROUND: Delirium is a commonly observed problem for adult patients in the intensive care unit (ICU) that is associated with increased mortality, increased hospital length of stay, and long-term disability of ICU survivors. This makes prevention and prompt treatment of delirium imperative goals for critical-care providers. Bedside critical-care nurses are uniquely poised to champion efforts to prevent, detect, and treat delirium but oftentimes are not aware of the most recent evidence-based guidelines or the potential long-term implications for the ICU survivor. Nurses have reported higher levels of confidence in detecting delirium, increased knowledge of delirium, and enhancement of patient care skills after receiving formal didactic educational training. OBJECTIVES: The objectives of this quality improvement project were to develop, implement, and evaluate a nursing education program for critical-care nurses that presented a protocol for the prevention and management of delirium in adult ICU patient populations, as well as improve nurses' familiarity, comfort, and compliance with using a standardized evaluation method for delirium and intervention care bundle. DESIGN: A didactic training program for bedside critical-care nurses was developed and implemented. Upon completion of the educational sessions, a daily bedside delirium screening and care bundle protocol were implemented for all patients in ICUs throughout the facility. PARTICIPANTS: Bedside critical-care nurses w...