Details

Autor(en) / Beteiligte

• Cody, Siobhan
• Lizarondo, Lucylynn
• McArthur, Alexa
• Barzen, Amy
• Ladera, Chris
• Levak, Serafina
• McAlary, Beth
• Misa, Olivia
• Senatore, Maria
• Tsigounis, Chrysafi
• Taylor, Joanne
• Thornton, Anna

Titel

Improving the quality of delirium practices in a large Australian tertiary hospital: An evidence implementation initiative

Ist Teil von

• Australian journal of advanced nursing, 2021-03, Vol.38 (2), p.3-12

Ort / Verlag

Melbourne: Australian Nursing & Midwifery Federation

Erscheinungsjahr

2021

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Objective: The aim of the evidence implementation initiative was to improve the quality of care delivered to hospitalised patients at risk of, or with, delirium through the implementation of best practice recommendations. Background: Delirium is a prevalent serious medical condition that remains unrecognised or misdiagnosed in acute hospitals and is therefore left untreated. This paper reports on a hospital-wide quality improvement project which was undertaken in recognition of the Australian Delirium Clinical Care Standard and as a response to the cumulative rate of hospital-acquired delirium within a health organisation in New South Wales, Australia. Methods: The quality improvement project used the JBI (formerly known as Joanna Briggs Institute) evidence implementation framework. Briefly, the JBI evidence implementation approach is grounded in the audit, feedback and re-audit process along with a structured process for the identification and management of barriers to compliance with recommended clinical practices. Twelve nurses, who received support from external facilitators (implementation researchers), acted as delirium champions. Results: Baseline audit of 143 patient notes showed poor compliance (range 6% - 67%) to recommended practices relating to screening, assessment, prevention and management of delirium. Barriers analysis revealed nurse-related (eg. lack of knowledge) and organisational level factors (e.g. absence of a hospital-wide policy/procedure for delirium management). A multicomponent strategy was implemented by all delirium champions in their respective units/wards. Follow-up audit of 151 patient notes demonstrated significant improvements in compliance with best practice recommendations for all aspects of delirium care. Discussion: The quality improvement activity highlighted that education remains one of the most important and critical first steps in facilitating change in clinical practice. Critical to the success of the project was