Creating a Culture of Delirium Assessment and Treatment

Beth Israel Deaconess Medical Center (Boston, Massachusetts)

CSI Summary

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CSI Presentation

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Project Topic

Delirium prevention and treatment

CSI Participants

Justin DiLibero, RN, MSN, CCRN, CCNS
Janice Moreira, RN, BSN
Annalyn Ninobla, RN, BSN
Allison Woods, RN, BSN

Project Goals/Objectives

  1. To achieve greater than 90 percent accuracy in delirium assessments using CAM-ICU tool
  2. To achieve greater than 90 percent inter-rater reliability in delirium assessments
  3. To facilitate meaningful interdisciplinary discussion around delirium assessment and sedation management (Road Map)
  4. To decrease benzodiazepine use 50 percent in patients with documented delirium

Project Outcomes

  1. Sustained greater than 90 percent accuracy in delirium assessments (greater than 80 percent in patients with altered RASS)
  2. Sustained 90 to 100 percent inter-rater reliability in delirium assessments
  3. Conducted meaningful interdisciplinary discussion around delirium assessment and sedation management
  4. Decreased Benzodiazepine use greater than 80 percent in patients with documented delirium
  5. Sustained zero percent benzodiazepine use in patients with documented delirium over four consecutive months
  6. Reduced the incidence of delirium 60 percent
  7. These outcomes resulted in an incremental cost savings per patient of $4,919, with a projected annual fiscal impact of $1,770,840.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.

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