Gerontology & Geriatric Research

Abstract

We can Do it: Nursing Educational Intervention to Increase Delirium Documentation

Stephanie Chow, Nadia Mujahid, Kristen Butterfield and Lynn McNicoll

Background/Objectives: Delirium is a widely recognized complication during hospitalization, but poorly documented. We examined the effectiveness of a geriatrician-guided delirium training intervention to increase nurses’ delirium documentation, knowledge, and self- confidence. Design: Prospective cohort study Setting: Orthopedic surgical inpatient unit Participants: Twenty-six nursing staff Intervention: Nurses participated in a geriatrician-guided delirium training intervention. Each nurse received two 45-minute didactic sessions on delirium causes, screening, and prevention using the Confusion Assessment Method (CAM). Measurements: Nursing delirium documentation pre- and post-educational intervention was determined during the months of March and June 2013. Nurses also completed a pre- and 3-month post-interventional survey to assess confidence and knowledge of delirium detection. Results: Nursing mean age was 46 years, with 17 years of experience. Patients with CAM documentation increased significantly post-intervention from 13 to 91% (p<0.001). On average, rate of nursing CAM documentation per shift increased from 5.5 to 70.8%, (p<0.001). Post-interventional nursing knowledge scores significantly improved from 44 to 73% correct (p<0.001). As compared to pre-intervention, nurses scored significantly higher on number of delirium risk factors from 32 to 71% (p<0.001), medications to avoid in the elderly from 20 to 70% (p<0.001), and correct management strategies for patients with delirium from 52 to 84% (p<0.001). Nurses’ confidence in detecting delirium increased significantly post-intervention from 7.8 to 8.6 points out of a 10-point scale (p=0.021). Conclusion: Nursing knowledge and documentation of delirium using the CAM, as well as nursing confidence in identifying delirium all significantly increased after formal geriatrician-guided educational intervention.