An educational strategy for the implementation of a delirium assessment tool
Open Access
- 10 August 2021
- journal article
- Published by Heighten Science Publications Corporation in Journal of Clinical Intensive Care and Medicine
- Vol. 6 (1), 015-020
- https://doi.org/10.29328/journal.jcicm.1001035
Abstract
Background: Delirium is an acute syndrome of organ dysfunction with long-term consequences which commonly occurs in the Intensive Care Unit (ICU). The incidence of delirium ranges from 30% - 50% in low severity ICU patients and up to 80% in mechanically ventilated patients. This condition is frequently under-recognized and daily routine screening is a key strategy to early intervention. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) are the most recommended assessment tools for detecting delirium in the critical ill patient. Objective: The main objective of this study is to educate ICU staff about delirium. In addition, nurses were trained to use the CAM-ICU as a standard screening tool. The intervention was evaluated through a survey aimed at ICU staff. Methods: An educational intervention was started in 2014 in our ICU. An educational package for ICU staff consisted of a didactic brochure and explanatory videos. One-on-one teaching, case based scenarios and didactic teaching were strategies used in the implementation process. The entire intervention was evaluated by means of a survey directed to the professionals. Results: The structure of the didactic brochure was simple in order to have an easy understanding of the CAM-ICU tool. We also created 10-minute videos. According to the results of the satisfaction survey (N=62), disorganized thinking was the most difficult feature of CAM-ICU to interpret. When in doubt, consultation between co-workers was the primary resource selected by unit staff. Conclusion: This initiative achieved the objective of training health care professionals in the application of the CAM-ICU tool with a good level of satisfaction from them. Therefore, ICU staff consider delirium management in the broader picture of critically ill patient care as a major activity of daily practice.Keywords
This publication has 25 references indexed in Scilit:
- The Methodological Approach Used to Develop the 2013 Pain, Agitation, and Delirium Clinical Practice Guidelines for Adult ICU PatientsCritical Care Medicine, 2013
- Implementing Delirium Screening in the ICUCritical Care Medicine, 2013
- Delirium: A review of the nurses role in the intensive care unitIntensive and Critical Care Nursing, 2012
- Validity and Reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patientsJournal of Critical Care, 2010
- Delirium epidemiology in critical care (DECCA): an international studyCritical Care, 2010
- Limitations and practicalities of CAM-ICU implementation, a delirium scoring system, in a Dutch intensive care unitIntensive and Critical Care Nursing, 2009
- Routine delirium monitoring in a UK critical care unitCritical Care, 2009
- Risk factors for delirium in intensive care patients: a prospective cohort studyCritical Care, 2009
- Combined didactic and scenario-based education improves the ability of intensive care unit staff to recognize delirium at the bedsideCritical Care, 2008
- Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care UnitJAMA, 2004