Document Type

Final Project

Graduation Date

Summer 8-9-2024

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. LeAnn R. Holmes

Abstract

Background

At a large, tertiary care hospital in the Midwest, it had been anecdotally noted that delirium or acute encephalopathy cases were increasing. Specifically, inpatient neurology consultations for delirium were on the rise. This data had been confirmed by hospital administration. Delirium has been identified as a well-known problem in elderly, hospitalized adults—most notably in elderly, postoperative adults. It can cause a cascade of additional complications for elderly patients. Delirium prevention is known to be the best method to combat delirium incidence. Prevention has been proven to occur by way of non-pharmacologic, early interventions by nursing. Bedside nursing staff must be given the tools to initiate these interventions. A teaching intervention on delirium was developed as one of these tools to answer the PICOT question: Does an education intervention for bedside post-op nurses improve their delirium knowledge?

Objective

The purpose of this study was to build an education program to promote nursing delirium recognition in a midwestern, tertiary hospital’s postoperative care units. The specific aims for this quality improvement project were: 1. Develop a delirium education program 2. Describe postoperative nurse’s pre and post-test delirium knowledge as measured with a delirium knowledge test.

Methods

A delirium teaching intervention was developed utilizing key prevention techniques from the literature, including the Hospital Elder Life Program. The delirium pretest was administered. The teaching intervention was delivered to bedside nursing staff in a discussion format with case studies as well as time for question and answers. A posttest was then administered to determine efficacy of the intervention.

Results

There was a total of 25 participants in two different education sessions. Statistics were calculated for the group as a whole. The mean pretest score was 72.15% answers correct with a standard deviation of 15.59 and a standard error mean of 3.12. The mean posttest scores for the cohort were 93.38% with a standard deviation of 6.71 and standard error mean of 1.34. Pre- and post-scores were compared within the nurses with a paired t-test. Computed t-statistic was -7.352 for a p value of

Conclusions

Use of an education intervention on delirium prevention increased bedside nursing staff’s knowledge, as measured immediately after the education. There was no difference in knowledge gained between the pre and posttest scores by years in the role. The findings of this pilot study are similar to findings from the limited studies identified in the literature studying education interventions on nursing knowledge. This study could be expanded at the tertiary care facility and incorporate data from chart reviews to include delirium incidence before and after the teaching. Future recommendations would be to incorporate delirium education into the routine educational offerings required at the tertiary care hospital and affiliated rural facilities.

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