Reducing Instance and Duration Of Delirium Through Skilled Communication

Project Topic:

ICU Liberation/ Delirium Reduction

Hospital, City and State:

Ochsner Main Campus, New Orleans, Louisiana

Unit:

• Medical Intensive Care Unit

CSI Participants:

• Kaitlyn McAuliffe, BSN, RN, CCRN
• Kimberly Gooden, BSN, RN
• Jessica Orlic, BSN, RN, CCRN
• Renee DeoCampo, MS-MFT, BSN, RN
• Co-Coach: Sonja Burks, BSN, RN, CCRN
• Co-Coach: Jonathan Nelson, BSN, RN, CCRN

Project Goals/Objectives:

1. Increase compliance with delirium recognition documentation to 75%
2. Increase staff knowledge regarding ICU delirium & preventative methods with greater than 75% of staff reached
3. HWEAT Skilled Communication score improve to 3.77 from 4.00
4. Decrease overall ICU ventilator days by 15%
5. Decrease average ICU length of stay (LOS) by 10%

Project Outcomes:

1. Compliance of delirium prevention and documentation increased to 82%.
2. Staff knowledge regarding ICU delirium & preventative methods increased with greater than 90% of staff reached
3. Decreased sedation practices with more ventilated patients being ambulated to chairs
4. ICU Length of stay decreased 11%
5. HWEAT Skilled Communication score improved 3.77 to 4.08

Project Overview:

The Medical Intensive Care Unit (MICU) at Ochsner Medical Center in New Orleans, Louisiana implemented a multidisciplinary quality improvement initiative aimed at reducing the incidence and duration of ICU delirium. Delirium is a common and serious complication among critically ill patients—particularly those requiring mechanical ventilation—and is strongly associated with prolonged ventilator days, increased ICU and hospital length of stay, and higher healthcare costs.

This project sought to address delirium through a comprehensive approach that combines evidence-based clinical interventions with targeted staff education. Current literature demonstrates that structured delirium prevention strategies—such as components of the ICU Liberation (ABCDEF) Bundle—can significantly reduce the duration of mechanical ventilation and ICU length of stay while improving overall patient outcomes.

The primary objectives of this initiative are to:

• Reduce the incidence and duration of ICU delirium
• Decrease average ventilator days
• Shorten ICU and hospital length of stay
• Improve staff knowledge, recognition, and management of delirium

A key focus of this project is identifying and addressing educational gaps among bedside staff related to delirium assessment, prevention, and management. Standardized education will emphasize consistent use of validated screening tools (e.g., CAM-ICU), sedation optimization, early mobility, sleep promotion, and environmental modifications to support cognitive recovery.

By improving adherence to evidence-based practices and enhancing interdisciplinary collaboration, this project aims to create a sustainable culture of delirium prevention within the MICU. The anticipated outcomes include improved patient safety, reduced resource utilization, and enhanced overall quality of care for critically ill patients.