Introducing delirium screening in a cardiothoracic critical care unit

Aim: To share an experience of introducing Delirium scoring into a Cardiothoracic Critical Care Unit and the lessons learnt. Background: Delirium has serious consequences leading to increased length of stay in hospital, the possible development of dementia with the associated need for long-term care and even death. It is therefore vital that the Critical Care nurses are able to prevent, recognize and manage delirium. Data sources and methods: 108 patients who were admitted over a 6 week period were audited and their delirium score, documentation and treatment plans were reviewed. Results: 21% of patients experienced delirium during their stay on Cardiothoracic Critical Care and hypoactive delirium was the most prevalent subtype. Of the three patients who stayed more than 20 days on critical care all suffered with delirium at some point during their stay. Documentation of delirium by both Nursing and Medical staff occurred in less than 50% of patients. Conclusions: The introduction of delirium scoring and audit of its practice has highlighted the incidence of delirium in critically ill patients and has resulted in; Improved quality of care by development of a delirium care bundle Improved recognition of delirium Instigation of practices to prevent and treat delirium