Date of Award

Spring 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Departments (Collect)

Graduate Nursing Department

Program or Major

Evidence Based Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Abstract

Introduction At a small, community hospital in Massachusetts a gap analysis was conducted leading to a quality improvement project to increase staff education and knowledge regarding delirium and evidence-based best practices for delirium care. Delirium is a growing, often under recognized medical condition that occurs in hospitalized patients (Loftus & Wiesenfeld, 2017). Delirium is characterized by acute changes in congnition, level of consciousness, and attention (Loftus & Wiesenfeld, 2017). A better understanding of this condition is expected to result in improved patient care.

Methods The clinical microsystem studied in this gap analysis project was assessed by using the AHRQ Gap Analysis tool, a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stakeholder feedback, and resource allocation.

Intervention Following discussion with the nursing education department, a gap was identified in the care for delirium patients within the microsystem. A pre-intervention delirium knowledge assessment was given to nursing staff which supported the need for increased education on this topic. The data from the survey showed that between 26.6- 53.3% of the risk factors and signs and symptoms tested on the survey were not identified correctly. A delirium “QuickNotes” tool was created as a method to provide easily accessible information on delirium care.

Results A post-intervention knowledge assessment survey was given to nursing staff following the presentation of the QuickNotes tool to the nursing staff. 100% of respondents were able to correctly identify the definition of delirium. . Of the 13 risk factor questions on the survey, 12 had 100% correct responses. Additionally, on the signs and symptoms portion of the survey, 8 of the 12 signs and symptoms had 100% correct responses. A free response text question was included in the survey asking respondents to name an adequate non-pharmacologic intervention for delirium which 100% of the respondents did correctly.

Discussion The intervention of the delirium “QuickNotes” tool was successful in increasing staff knowledge and awareness of delirium in the hospitalized patient. The gap analysis project has succeeded in its objectives and has facilitated discussion for next steps involving delirium care including the use of a validated screening tool in the future as well as continued education on this topic.

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