Click here for presenter slides from this symposium (meeting-attendee login required).
Delirium is common and often under recognized neuropsychiatric condition commonly associated with poor outcomes and high costs. In 2010, the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom released a guideline that addressed the diagnosis, prevention, and management of delirium. The guideline made specific recommendations about the provision of an intervention package tailored for patients at risk for delirium. The multicomponent intervention package included assessment and modification of key clinical factors that may precipitate delirium (dehydration, sleep disturbance, pain, constipation, hypoxia, infection, immobility, medications, poor nutrition, sensory impairment, and sleep disturbance. The full version of the guideline may be found at
http://guidance.nice.org.uk/CG103. This symposium will detail the development, implementation, and preliminary results of NICE-based delirium identification and prevention protocol within a hospital care system consisting of academic and non-academic hospitals.
Thomas Heinrich, MD (MCW) will moderate the symposium and present a brief review of the key elements of NICE's clinical guidelines on the identification, prevention and management of delirium. Six Sigma process improvement (Stephen Schilz - Froedtert Hospital) and Thomas Heinrich will speak about the process management, identification of appropriate metrics, and dashboard development. Nursing administration (Jeri Smith, APNP and Danielle Siclovan, MSN - Froedtert Hospital) will speak on the implementation of universal delirium screening and multidisciplinary prevention measures in the at risk patient population. Travis Fisher, MD (MCW) will talk about the development of a delirium management tool and order set within the EpicCare medical records system and the unique aspects of the implementation of this delirium prevention, identification, and treatment protocol in our community hospital partners. Results of the program to date will then be discussed.
The session will conclude with an approximately 30 minute question and answer period.
