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Sturgeon Community Hospital

Sturgeon Community Hospital. ICU Delirium Collaborative November 2012. Background . 5 funded beds in ICU (frequently flexing up to 6 beds as needed) within a 15 bed critical care unit. Part of the Edmonton Zone Critical Care Network Patient population a mix of Surgical and Medical patients.

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Sturgeon Community Hospital

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  1. Sturgeon Community Hospital ICU Delirium Collaborative November 2012

  2. Background • 5 funded beds in ICU (frequently flexing up to 6 beds as needed) within a 15 bed critical care unit. • Part of the Edmonton Zone Critical Care Network • Patient population a mix of Surgical and Medical patients

  3. Aim Improve care of the critically ill patient at risk for delirium with the implementation of standardized screening and identification of prevention and management strategies in the ICU Goals/Objectives: • Develop and deliver education and support for staff regarding delirium awareness, prevention and management within 12 months • Implement processes to screen 100% of all ICU patients for delirium within 6 months or less • Determine baseline incidence of delirium within 3-4 months • Identify and implement standardized prevention interventions and management treatments for delirium in all ICU patients within 12 months • Implement strategies to support families of patients with delirium within 18 months or less.

  4. Team Members • Physicians • Registered Nurses • Nurse Clinician • Physiotherapy • Social Work • Spiritual Care • ICU Patient Care Manager

  5. Results • Screening using ICDSC tool • October 2011 – 25% compliance • October 2012 – 100% compliance • Early mobilization • Protocol implemented May 2012 • Prior to implementation the mobilization of patients was inconsistent and limited to 0 to 1 times a day. • October 2012 patients are being mobilized 2 times a day for 20 minutes or greater at a time. (goal 20 minute interval 3 times a day)

  6. Changes Tested • ICDSC tool compliance • Reporting of ICDSC at daily interdisciplinary lean rounds and at handover of care • Implementation sleep promotion activities • Implementation and documentation of early mobility

  7. Lessons Learned • Keys to success • Physician support • Dedicated resource allocation • Dedicated consistent physio support • Ongoing daily educational support to the front line staff • Clear communication between all interdisciplinary team members • Small steps • Challenges • Change takes time • Old practices and beliefs are hard to let go of

  8. Next Steps • Continue educational support to the front line staff • Reduction of restraint use in the ICU • Continue data collection on screening compliance, and incident of delirium. • Roll out Delirium information pamphlet for family. • Updating of Sedation Protocols

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