4.

12 Standardised Care of the Critically Ill Patient

6. All patients must be screened daily for evidence of delirium using a validated method such as the Confusion
Assessment Method for the ICU (CAM-ICU) or the Intensive Care Delirium Screening Checklist (ICDSC)

https://www.icudelirium.org/medical-professionals/delirium/monitoring-delirium-in-the-icu
resources for cam icu training

https://www.rcoa.ac.uk/sites/default/files/documents/2020-08/21075%20RCoA%20Audit%20Recipe%20Book_18%20Section%20B.9_p287-310_AW.pdf
RCOA recipe toolkit

https://www.rcoa.ac.uk/sites/default/files/documents/2020-08/21075%20RCoA%20Audit%20Recipe%20Book_SECTION%20A_28.08.2020.pdf
RCOA reading about QI methodology =/
 Nursing RASS Nursing delirium Daily review cognitive Nursing delirium Positive delirium Positive screen acted upon in
Date Bed no score? Y/N screen? Y/N assessment? Y/N screen accurate? Y/N screen? medical notes?
 Aims
Plan Assess practice of delirium screening and monitoring on ITU
Improve screening practice for delirium by nursing and medical staff
Improve rates of acting on positive delirium screen
Relevant to GPICS and GPAS standards

Methods
Do Intial audit - prospective 3 day data collection, review of nursing chart and medical notees
Assessment of presence of documentation of delirium assessment
Spot check of accuracy of nursing delirium screen, if performed

Plan to:
Do/ Act provide bedside education of delirium screening to nurses over 1-2 week period
education to medical staff, advocate actioning of positive delirum screen eg. drug chart review, sleep bundles
suggest new edition of cam-icu sheets if relevant?

Study Re-audit over 2 separate 2 day periods to ensure sustainable change

Do Stakeholders to involve:
Consultants - advocate delirium awareness
Is there a nurse link for delirium? Involve in providing education?
Nurse in charge on days of data collection / bedside education