Date of Conferral

3-26-2025

Date of Award

March 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

LILO FINK

Abstract

Summary This doctoral project developed a clinical practice guideline (CPG) to address the critical health issue of early identification of delirium among hospitalized high-risk patients. Hospital delirium is associated with prolonged hospital stay, increased nursing home or rehab use after hospitalization, and higher mortality. Evidence shows that systematic screening improves delirium identification among hospitalized high-risk adults. However, there was no clinical practice guideline for delirium screening at the project facility for high-risk, non-intensive care unit patients. Therefore, the practice-focused question for the project was, “Does the evidence support the development of a CPG for delirium screening in high-risk hospitalized patients that was validated by an expert panel via the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and approved for use in the practice setting by end-users? The purpose of this project was to provide best practices for the early screening of delirium among hospitalized high-risk patients. The Johns Hopkins evidence-based tool was used to organize the 20 articles of evidence supporting the project. An expert panel of four evaluated the CPG using the AGREE II Instrument. The results showed quality scores in all six domains ranging from 87.5% - 97.2%. The project's overall quality score was 89.2%, and the guideline was accepted for use in practice. Implications for nursing practice include the use of this CPG for enhanced identification of delirium to improve delirium outcomes by ensuring equitable screening of all high-risk patients. This project, therefore, aligns with social change goals of diversity, equity, and inclusion in care.

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