Shared learnings and results from the Delirium Med Rec Collaborative

1. ICU West Delirium Project
1

2. How did we implement
knowledge into practise?
 We completed several PDSA cycles
 Lunch and learns about delirium and the
importance to think of it as a medical
emergency were done for staff of our 3 ICUs at
the General site.
 Our physician assistant and the MD staff made
it a priority to discuss on rounds.

3. How did we implement
knowledge into practise?
 We completed several PDSA cycles
 Lunch and learns about delirium and the
importance to think of it as a medical
emergency were done for staff of our 3 ICUs at
the General site.
 Our physician assistant and the MD staff made
it a priority to discuss on rounds.

4. Audit and Feedback
 We did spot audits once a week to check
compliance of the staff for completing the CAM
and gave away coffee cards as incentive.
 Week long full audits of compliance to complete
the CAM assessment, as well as incidence of
delirium were also done monthly.
 These were reported back to staff.
 We purchased a case to display the results to
staff and visitors.

5. Compliance with
Spot Audits
100
Percentage of completed CAM scores
90 GOAL
80
70
60
50
40
30
20
10
0
Time

6. Incidence of delirium
50
Percentage of patients with a minimum of one
45
40
35
positive CAM score
30
25
20
15
10
5
0
Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12
Time

7. Sharing our data…

8. Broaden the knowledge...
 Both sites (total of 5 ICUs) joined forces and
knowledge.
 We organized 4 hour retreat for staff to bring
awareness to delirium detection, management and
the importance of early mobilization.
 A survey was completed by retreat participants
prior to and following the presentations to assess
knowledge gained and where there was a need for
more education.
 After the retreat, an article was publicized in ‘The
Insider”, our hospital newsletter.

9. Moving forward…
 The RASS score was added to our electronic
documentation and we are integrating sedation and
delirium assessment.
 Our latest and most exciting news is that the two
sites, working in conjunction, have applied for a
knowledge translation grant, so that we can
continue to improve our delirium management and
getting our ICU patients mobilized earlier

10. Our next goal to
reduce delirium