Delirium-Prevention Protocol Has Major Impact on ICU

A new standard of care for reducing delirium, based on nursing interventions and developed by nurses at a Philadelphia hospital, is better for patient outcomes and for nurses.

For Anne Jadwin, RN, MSN, AOCN, NE-BC, vice president of nursing and CNO at Fox Chase Cancer Center, in Philadelphia, getting the chance to participate in the American Association of Critical-Care Nursing's Clinical Scene Investigator (CSI) Academy was a little like serendipity.

She and the ICU committee had just been discussing the need to do more delirium prevention in their ICU, since literature shows that delirium among critical care patients can not only be debilitating in the short-term, but also lead to long-term cognitive impairments.

The following week, Jadwin got an email about the CSI Academy, a 16-month, hospital-based nurse leadership and innovation training program funded by the AACN. Immediately, her mind traveled to that ICU committee meeting, and she knew the delirium project would be perfect.

Once Fox Chase was selected as one of the seven hospitals to participate in the Pennsylvania cohort, "we had no trouble finding four staff nurses that wanted to participate in this project," she says.

At the core of the project was a delirium-prevention protocol, a risk-assessment and screening tool that creates a risk score for patients using measurements such as the confusion assessment method, and assigns certain types of interventions based on that score.