Date of Award

4-2019

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Marie VanderKooi, DNP, MSN, RN-BC

Second Advisor

Sandra Spoelstra, PhD, RN, FGSA, FAAN

Third Advisor

Nicole Wills, MSN, RN

Fourth Advisor

Nancy Bekken, RN, MS, CCRN

Abstract

Delirium is associated with increased mortality, nosocomial complications, increased length of hospital stay, and greater chance of readmission, increased hospital costs, and a need for skilled nursing aid after discharge from the hospital. In a hospital, delirium can affect up to 50 percent of older patient 65. The solution is to prevent delirium from occurring and to regularly screen for its presence. The purpose of this paper is to explore the best prevention strategies and screening tool for delirium and to successfully implement a delirium bundle on a medical surgical unit. The question this paper attempts to answer is if implementation of a delirium bundle will decrease adverse patient events such as falls, restraints, and safety attendant use. The goal of this quality improvement project is to increase use of delirium prevention techniques, increase use of a screening tool, and to decrease adverse patient events. The quality improvement project will take place on a neuroscience medical surgical unit which does not have a delirium policy or procedure in place. Nursing staff will be educated on delirium, its prevention, and the Confusion Assessment Method (CAM) for Intensive Care Units (ICU). After education, nursing staff will be expected to implement learned techniques. Pre-data will be collected to compare to post data regarding prevention techniques, use of the CAM-ICU, and overall rates of falls, safety attendants, and restraint use. It is expected that falls, restraints, and safety attendant use will decrease, and delirium prevention techniques will increase. Current nursing practice will change by implementing the CAM-ICU, which can lead to earlier detection of delirium.

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