CSI Project

Creating a Culture of Delirium Assessment and Treatment

Beth Israel Deaconess Medical Center (Boston, Massachusetts)

CSI Summary

Available only to registered AACN.org users.

Summary

CSI Presentation

Available only to registered AACN.org users.

Presentation

CSI Toolkit

Available only to users with a paid AACN membership.

Toolkit

Added to Collection

Project Topic

Delirium prevention and treatment

CSI Participants

Justin DiLibero, RN, MSN, CCRN, CCNS
Janice Moreira, RN, BSN
Annalyn Ninobla, RN, BSN
Allison Woods, RN, BSN

Project Goals/Objectives

  1. To achieve greater than 90 percent accuracy in delirium assessments using CAM-ICU tool
  2. To achieve greater than 90 percent inter-rater reliability in delirium assessments
  3. To facilitate meaningful interdisciplinary discussion around delirium assessment and sedation management (Road Map)
  4. To decrease benzodiazepine use 50 percent in patients with documented delirium

Project Outcomes

  1. Sustained greater than 90 percent accuracy in delirium assessments (greater than 80 percent in patients with altered RASS)
  2. Sustained 90 to 100 percent inter-rater reliability in delirium assessments
  3. Conducted meaningful interdisciplinary discussion around delirium assessment and sedation management
  4. Decreased Benzodiazepine use greater than 80 percent in patients with documented delirium
  5. Sustained zero percent benzodiazepine use in patients with documented delirium over four consecutive months
  6. Reduced the incidence of delirium 60 percent
  7. These outcomes resulted in an incremental cost savings per patient of $4,919, with a projected annual fiscal impact of $1,770,840.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.