Assessing the utilization of CAM -ICU in the early detection of delirium in the General Intensive Care Unit

G. Hunduma, S. Bathia, M. Shah, D. Richardson

Background

Assessing intubated patients for delirium is difficult which further emphasises the importance of ensuring that daily assessm ents are being performed in addition to ensuring that staff involved directly in the care of patients are competent in performing these assessments. Lack of daily CAM-ICU assessments results in delirium going undetected and therefore worsened patient outcomes and prognosis. The aim of this QIP was to perform a prospective analysis of the use of CAM-ICU on 30 intubated in the General Intensive Care Unit (GICU).

Objective

•To assess and improve the detection rates of delirium from the day of patient admission into the GICU using the CAM-ICU

•To assess staff competence and confidence in using CAM-ICU

•To determine factors preventing effective utilisation of CAM-ICU

Methodology

•The effects of the planned changes will be assessed using a combination of observation of new admissions on the Metavisionsoftware used in the GICU, and questionnaire of the nurses and doctors involved in their patient’s care.

•We planned an education session for staff with an aim of re-assessing the use of CAM-ICU after 1 month among the nurses and doctors involved in their patient’s care.

Results:

The PDSA 1:

•Newly admitted patients identified

•Exclude patients with RASS>-2