Amanda Riley


Improving Delirium Nursing Assessment and Intervention in the Acute Care Setting

Purpose: The purpose of this project is to explore the potential benefits of early identification of delirium for geriatric patients in the acute care setting using a standardized assessment tool.

Methods: This quality improvement project was a retrospective chart review exploring the effectiveness of the bCAM assessment tool in identifying delirium in geriatric patients. Target population consists of geriatric patients age 65 and older with variable diagnoses. The hospital protocol consists of registered nurses on the 3 units to conduct bCAM assessments every 12 hours for every patient who had a positive delirium screening. Chi-square tests of linear trend were used on the aggregated data for each aim to test for significant change across the six months of observation, October 2019 through March 2020.

Results: The rate of use of the standardized assessment in this study revealed overall increasing use and identification each month following staff education and the implementation of the delirium protocol. The statistical significance was mixed depending on the unit; however, the results of the QI project are consistent with other studies that revealed an improvement of the assessment technique utilization through nurse driven quality initiatives. This study revealed that there were no significant trends of the type of nursing interventions employed and documented.

Discussion: This study demonstrates that nurses in the acute care setting can have a positive effect on geriatric patient outcomes with future quality improvement projects aimed at increased early identification of delirium and swift treatment interventions.

Conclusions: The geriatric population continues to grow and age, so will the demands on the healthcare system at large. Nurses in the acute care setting must be prepared for focusing on the geriatric patient needs and enhance the interventions implemented and healthcare services provided with an emphasis on decreasing morbidity and mortality. Assessment is a top tenet to all nursing practice and a foundational aspect in this study.

Major Professor: Susan Porterfield, PhD, FNP-C






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