Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Cheryl Bos

Second Advisor

Joy Turner-Washburn

Academic Year



Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and use of BEERS medications were tracked.

Methods: Mixed methods were used to collect retrospective and prospective data for this quality improvement project. Quantitative data of adults 70 years and older from chart audits on two pilot units (n=25, n=25) established a baseline. Prospective data (n=106, n=123) collected after implementation and evaluated using SPSS to assess significance. Likert scales (n=23, n=9) were used to assess impression and usability of assessment and interventions.

Results: Unit A delirium rate decreased from 32% to 9.75% (n=25, n=236), p=.004; Unit B rate decreased from 32% to 13.37% (n=25, n=187), p= .034. Two-sample Z tests of proportion showed statistical significance with p< .05. Descriptive statistics analyzed Pre and Post measurements.

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