Evaluating the Feasibility and Effectiveness of a Delirium Prevention Bundle in Hospitalized Critically Ill Patients

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Hdl Handle:
http://hdl.handle.net/10755/304518
Category:
Full-text
Type:
Presentation
Level of Evidence:
Controlled Trial
Research Approach:
Quantitative Research
Title:
Evaluating the Feasibility and Effectiveness of a Delirium Prevention Bundle in Hospitalized Critically Ill Patients
Author(s):
Smith, Claudia DiSabatino; Grami, Petra
Lead Author STTI Affiliation:
Zeta Pi
Author Details:
Claudia DiSabatino Smith, PhD, RN, NE-BC, csmith1@sleh.com; Petra Grami, BSN, RN, CVRN II, NE-BC;
Abstract:

Session presented on: Tuesday, July 23, 2013

Purpose: The purpose of the research study was to evaluate the effectiveness of a delirium prevention bundle in reducing the incidence of delirium in hospitalized critically ill adult patients.

Methods: A prospective, interventional cohort study was conducted in two similar medical surgical ICU units in a large, tertiary care facility in southeast Texas. Data collection included use of: the RASS 1, a dichotomous scoring system that ranges from +4 agitation to -4 sedation; the CAM-ICU2-6 , a bedside test that assesses for delirium; and a researcher-generated Delirium Data Collection Tool.

Results: Sample size consisted of n=668 patients and 2687 observations. In the control unit, the odds of developing delirium increased 2.5% for every day hospitalized in the unit.' In the intervention unit, the odds of developing delirium decreased 4.8%/day. The overall treatment effect reduced the odds of delirium by 7.1% (p=0.021). When adjusting for age, co-morbidities, and LOS, the overall significance of the adjusted model is p< 0.0001. Patients in the control unit have a 1.7% chance of developing delirium each day, while patients in the intervention unit are 6.1% less likely to develop delirium. The overall treatment effect reduced the odds of delirium by 7.7% (p= 0.012).' While gender was not associated with delirium, females are 13.7% more treatable, and the treatment effect reduced the odds of developing delirium by 10.7%. Patients in the intervention group, age 65-74, were 13.7% less likely to develop delirium; treatment effect was 21.9% (p=0.001).

Conclusion: The intervention bundle significantly reduced the incidence of delirium in certain critically care patients. Hospitals should consider implementing a core model of delirium prevention care that combines evidence-based strategies with nursing interventions that are integrated into routine ICU care.

Keywords:
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Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.evidence.levelControlled Trialen
dc.research.approachQuantitative Researchen
dc.titleEvaluating the Feasibility and Effectiveness of a Delirium Prevention Bundle in Hospitalized Critically Ill Patientsen
dc.contributor.authorSmith, Claudia DiSabatinoen
dc.contributor.authorGrami, Petraen
dc.contributor.departmentZeta Pien
dc.author.detailsClaudia DiSabatino Smith, PhD, RN, NE-BC, csmith1@sleh.com; Petra Grami, BSN, RN, CVRN II, NE-BC;en
dc.identifier.urihttp://hdl.handle.net/10755/304518-
dc.description.abstract<p>Session presented on: Tuesday, July 23, 2013</p><b>Purpose: </b>The purpose of the research study was to evaluate the effectiveness of a delirium prevention bundle in reducing the incidence of delirium in hospitalized critically ill adult patients. <p><b>Methods: </b>A prospective, interventional cohort study was conducted in two similar medical surgical ICU units in a large, tertiary care facility in southeast Texas. Data collection included use of: the RASS<sup> 1</sup>, a dichotomous scoring system that ranges from +4 agitation to -4 sedation; the CAM-ICU<sup>2-6</sup> , a bedside test that assesses for delirium; and a researcher-generated Delirium Data Collection Tool. <p><b>Results: </b>Sample size consisted of n=668 patients and 2687 observations. In the control unit, the odds of developing delirium increased 2.5% for every day hospitalized in the unit.' In the intervention unit, the odds of developing delirium decreased 4.8%/day. The overall treatment effect reduced the odds of delirium by 7.1% (p=0.021). When adjusting for age, co-morbidities, and LOS, the overall significance of the adjusted model is p< 0.0001. Patients in the control unit have a 1.7% chance of developing delirium each day, while patients in the intervention unit are 6.1% less likely to develop delirium. The overall treatment effect reduced the odds of delirium by 7.7% (p= 0.012).' While gender was not associated with delirium, females are 13.7% more treatable, and the treatment effect reduced the odds of developing delirium by 10.7%. Patients in the intervention group, age 65-74, were 13.7% less likely to develop delirium; treatment effect was 21.9% (p=0.001). <p><b>Conclusion: </b>The intervention bundle significantly reduced the incidence of delirium in certain critically care patients. Hospitals should consider implementing a core model of delirium prevention care that combines evidence-based strategies with nursing interventions that are integrated into routine ICU care.en
dc.subjectTYPE NEW KEYWORD HEREen
dc.subjectTYPE NEW KEYWORD HEREen
dc.subjectTYPE NEW KEYWORD HEREen
dc.date.available2013-10-22T20:37:50Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:37:50Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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