Victoria Hospital, Critical Care Trauma Center (CCTC)

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Presentation transcript:

Victoria Hospital, Critical Care Trauma Center (CCTC) Delirium: Moving from Screening to Management

Our Team Critical Care Trauma Centre (CCTC) 30 Bed Adult Medical-Surgical-Trauma Intensive Care Unit Dr. Claudio Martin (Faculty) Brenda Morgan (Chair-Clinical Nurse Specialist) Dawna VanBoxmeer (Manager), Alison Rowlands (Co-ordinator CCTC) Krista Shea (Educator) Sherri Barton (RN) Amber Davis (RN) Julie Esbaugh (RN) Angela Walsh (RN) Elke Bohdanowicz (Pharmacist) Dr. Jennifer Barr (Psychiatrist)

Healthcare Provider Perception Study Evaluation of Delirium Project Collection January – February, 2012ed Data collection ends November 30, 2012 Completed July 30, 2012ed

Implementation of Routine Delirium Screening Protocol Inservicing completed on the significance of delirium and method for delirium screening (August 2012): 92.1% (N130) of nursing staff 60% (N3) of Physiotherapists 3% (N2) of Respiratory Therapists Web-based education and Delirium Resource Centre launched 3 Step Approach to Delirium Screening: Assess pain, treat and titrate pain medications (Tools: self-report, Numeric and visual analog, Critical Care Pain Observation Tool (CPOT) Assess sedation level and titrate medications (Tools: VAMASS) Screen for Delirium using Intensive Care Delirium Screening Checklist

Web-Based Delirium Resource http://www.lhsc.on.ca/Health_Professionals/CCTC/elearning/DeliriumResourceCentre.htm Prevention launch December 3, 2012 Module 2: Prevention/Management December 3, 2012 Management launch December 3, 2012 16-Nov-18 Delirium and Med Rec Collaborative

Changes to Documentation Revised Assessment & Intervention Flowsheet (Neuro Assessment) Fluctuation Reminder to document sleep-cycle (Days and Nights) on 24 H Graphic 16-Nov-18 Delirium and Med Rec Collaborative

Family Education: Website/Brochure

Bedside Tools

Delirium and Med Rec Collaborative Implementation of Routine Delirium Screening Protocol (August 30, 2012) 16-Nov-18 Delirium and Med Rec Collaborative

Prevention and Management Protocol Launch: December 3, 2012 16-Nov-18 Delirium and Med Rec Collaborative

Prevention and Management Protocol Bedside Appendices 16-Nov-18 Delirium and Med Rec Collaborative

Delirium Prevention Model Test Yourself!

Next Steps Education and roll out of prevention and management guidelines (December ‘12) Ongoing compliance monitoring Evaluation and tweaking Phase III: Introduction of “About Me” (January-February ‘12) ETOH prophylaxis protocol (January-February ’13) Trial of patient diaries (January-February ’13) Early mobilization CQI (January ’13)