Date of Award

Summer 2021

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner

Department

Nursing

Faculty Chair

Douglas Stephens, DNP

Preceptor

Andrew Barker, MD

Abstract

Delirium is an acute syndrome of the central nervous system (CNS) that affects patients of all ages and all hospital areas. Furthermore, delirium can lead to frequent complications for these patients, especially those in intensive care units (ICU) (Kanova, Sklienka, Burda, & Janoutova, 2017). Nationally delirium affects 20-80% of patients that require ICU care (American Nurses Association, 2019). In the Surgical intensive care unit (SICU) at the acute care hospital used in the project, the average number of patients suffering from delirium is about 23%. The purpose of this project was to provide a more in-depth analysis of delirium, and to address the effects of four times a day assessments versus per shift assessments, or twice daily, which is the standard of care in the SICU. This project was a quality improvement initiative that incorporated a quasi-experimental design analyzing retrospective data collected on delirium incidences when two assessments were performed versus data collected over a four-month period where four assessments were performed. The project’s results showed that the increase in frequency of the CAM-ICU assessments to four times a day yielded an average of 5.3-8.3% decrease in incidence of delirium in the SICU over four months and that the average incidences of delirium went from 23% to 16.7%. Nursing implications: This project provides evidence-based data showing that delirium assessment is vital to the quality of care provided to patients. Furthermore, it shows that the more aware both nurses and providers are of the risk factors for delirium, the more equipped they are to prevent the development of delirium.

Included in

Nursing Commons

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