Delirium Prevention, Screening, and Response in a Pediatric Intensive Care Unit
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Authors
Meeker, Ashley
Issue Date
2023-05
Volume
Issue
Type
Manuscript
Language
Keywords
Quality Improvement , ICU Delirium
Alternative Title
Abstract
Delirium is a highly prevalent complication of critical illness which is associated with significant morbidity, mortality, and healthcare costs. Pediatric delirium is vastly underdiagnosed and undertreated without routine screening. Despite the availability of validated screening tools and evidence-based delirium prevention recommendations for pediatric patients, many organizations do not implement routine delirium prevention or screening measures. The purpose of this quality improvement project was to create and implement a pathway to guide delirium prevention, screening, and initial management in a pediatric intensive care unit (PICU). The delirium pathway was developed through literature review and interdisciplinary collaboration. Interdisciplinary staff education was provided, and a smart phrase was created to facilitate screening while awaiting electronic medical record (EMR) integration. A total of 163 PICU patients were cared for during the 10-week project timeframe. Overall compliance with twice-daily delirium screening was 85%. Unit incidence rate was determined via manual chart review for a 4-week timeframe and was found to be 25%, which is consistent with the literature. Recommendations to improve pathway compliance include ongoing interdisciplinary education and EMR integration in the form of updated order sets, flowsheet-based screening, and related best-practice advisories. Ultimately, this project illustrates the importance and feasibility of delirium pathway integration in the PICU setting.
Description
Citation
Publisher
Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University