Date of Award

Summer 2026

Abstract

Abstract

Background

Delirium prevention is an ongoing patient safety priority within a Medical Intensive Care Unit (MICU) because delirium contributes to preventable patient harm, including unplanned device removal, prolonged mechanical ventilation, falls, increased mortality, and long-term cognitive impairment. Key signs of delirium include fluctuating awareness, severe confusion, disorganized thinking, and difficulty focusing. Although the ABCDEF bundle is established within the local MICU, an implementation gap remained in consistently integrating nonpharmacologic prevention strategies into routine nursing workflows.

Methods

The purpose of this quality improvement project was to improve nurse confidence, awareness of workflow opportunities, and implementation of evidence-based delirium prevention interventions in the MICU. Findings from the 5 P assessment informed development of a workflow-based educational intervention consisting of a brief educational PowerPoint™, online resources, and workflow reminder posters.

Intervention

The intervention consisted of a brief educational PowerPoint™, online resources, and workflow reminder posters designed to support integration of evidence-based delirium prevention into routine workflow.

Results

The intervention demonstrated greatest improvements in nurses’ perceived ability to identify workflow opportunities, understanding of when to imitate prevention interventions, and delirium prevention as feasible despite competing priorities. Strong agreement that nurses understood when to initiate delirium prevention increased from 47% before the intervention to 100% after the intervention, while strong agreement that delirium was feasible despite competing priorities increased by 36%. High pre-survey knowledge scores supported that the implementation gap reflected workflow integration rather than a knowledge deficit.

Conclusion

Delirium remains a common, preventable complication in critically ill adults. The project addressed an implementation gap rather than a knowledge deficit by helping nurses determine when and where to integrate evidence-based delirium prevention into existing workflow. Small workflow changes may improve integration of evidence-based practices without increasing perceived time spent in the patient’s room or documentation burden.

 

Document Type

Master's Thesis

First Advisor

Deborah Simonton EdD, MSN, RN, CNL

Second Advisor

Brianna Bagalio DNP, RN, CCRN, CNL

College or School

CHHS

Department or Program

DEMN

Degree Name

Master of Science

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