Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Joanne Minnick

Abstract

Delirium is a frequent complication of intensive care unit (ICU) admissions manifesting as acute confusion with inattention and disordered thinking. Patients in the ICU who develop acute delirium are more likely to experience long term disability and mortality. The purpose of this doctoral project was to evaluate an existing organizational quality improvement project to guide recommendations on improving care in the ICU. The practice-focused research question was: Does improving adherence to the ICU Liberation ABCDEF bundle for patients admitted to the ICU decrease incidence of delirium compared to outcomes prior to implementation? The Program Logic Model served as a framework for analysis of the organization's planning and implementation of this quality improvement project. Benchmark data from an organization's participation in the ICU Liberation Collaborative served as the primary source of evidence for analysis of outcomes. In addition, baseline data on current practice and outcomes in the organization's trauma ICU was analyzed and compared to the benchmark data. Analyses of data revealed strengths and opportunities for improvement in both the organization's project management and in current practices supporting adherence to the ABCDEF bundle guidelines. Incidence of delirium remained unchanged and far below national averages indicating need for further investigation into practices to verify this finding. Better prevention, identification, and management of delirium will lead to a positive impact on society, as patients who develop delirium rarely return to their baseline level of functioning.

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