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ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓

Published byHerbert Summers Modified over 9 years ago

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Presentation on theme: "ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓"— Presentation transcript:

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2 ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

3 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

4 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

5 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

6 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Phase I: Is there an Implementation-Problem? Phase I: Is there an Implementation-Problem?

7 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

8 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

9 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Perfectamundo?

10 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Perfectamundo?

11 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Im-Perfectamundo!

12 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

13 Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence?

14 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

15 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Phase I: Is there an Implementation-Problem Phase I: Is there an Implementation-Problem

16 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Phase I: Is there an Implementation-Problem: YES!? Phase I: Is there an Implementation-Problem: YES!?

17 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

18 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Phase II: Effects of Implementation Phase II: Effects of Implementation

19 Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis

20 ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence?

21 ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence?

22 ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis 1.Current Practices 2.Survey and Focusgroup interviews 3.Development and Description of a Tailored Implementation Strategy for an ICU Delirium Guideline Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence?

23 ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate ICU Delirium is a clinically relevant form of Organ Dysfunction in the Critically Ill ✓ Increased mortality ✓ Increased LOS at ICU ✓ Increased costs ✓ Possibly increased complication rate Implementation of Dutch ICU Delirium Guideline Adherence to Dutch ICU Delirium Guideline? Dutch ICU Delirium Guideline Prevention, Screening, Treatment Dutch ICU Delirium Guideline Prevention, Screening, Treatment Aim ✓ Improved Outcome after ICU treatment Aim Center-Tailored Implementation of Guideline Barrier-and-Facilitator Analysis 1.Current Practices 2.Survey and Focusgroup interviews 3.Development and Description of a Tailored Implementation Strategy for an ICU Delirium Guideline 5.Cost-effectiveness of a Tailored Implementation of an ICU Delirium Guideline 4.Effect of a Tailored Implementation of an ICU Delirium Guideline on Complications and Mortality Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence? Effects of Improved Adherence to Guideline (Before-After Design)? ✓ Mortality? ✓ LOS at ICU? ✓ Costs? ✓ Complications? ✓ Delirium Incidence?

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