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Delirium Collaborative. Aim. By July 2013, 100% of inpatients 65 years and older in ward 4 of Middlemore hospital will be screened using the Confusion Assessment Method (CAM) tool for 5 consecutive days from admission. They will have the delirium pathway implemented and
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Aim • By July 2013, 100% of inpatients 65 years and older in ward 4 of Middlemore hospital will be screened using the Confusion Assessment Method (CAM) tool for 5 consecutive days from admission. • They will have the delirium pathway implemented and documented appropriately to reduce preventable complications associated with delirium. The Counties Manukau Health Delirium Symbol
Key Changes • A comprehensive education package regarding an overview of delirium, how to use the CAM and how to implement the intervention package was given to all ward staff. • The adaptation of a robust, easy to use screening tool (CAM) allowing for the increased identification of delirium and detection of a potential delirium developing. • An intervention package which is simple, quick to implement, cost effective, encompasses the multi-disciplinary team and improves patient care through promoting best practice. This includes a patient/family information booklet ensuring education and understanding. • A delirium stamp and computer prompts to encourage diagnosis in the patients EDS.
Champion Package • 1A Delirium Education Spread ppt • 2A CAM Presentation ppt • 3A Intervention Presentation ppt • 1B Delirium Patient Story Video • 2B Delirium Project Video • 3B CAM Intervention Video • 1C 3D’s Handout • 2C How to..CAM Tool Practice Session • 3C CAM Intervention Sheet & Checklist • 2D CAM Tool pdf • CMH Guideline • 20,000 Days Pamphlet • Role of Delirium Champions • Delirium A Review pdf • Article on Delirium pdf • Brief Guide to Delirium pdf • 20,000 Days – Delirium Video • Delirium Management Pathway Education Package Staff Package CAM Tool Assessment Package Audit Tool CAM Compliance Placement of CAM tool Process Map WiMs Prompt Intervention Package Change Package CAM Intervention Check list • Pharmacy review • Environment • Family • Hearing • Vision • Nutrition/hydration Patient Room sign Information Pamphlet for Family CMH Delirium Guideline Watch Folder Delirium Coding Stamp Documentation Communication/ IT/Coding Delirium as diagnosis in EDS iPMs flag Version Control Date: 5/6/13 Owner: D Farrell Folder: 20,000 Days/HOP/Delirium/Change Package Early Delirium Identification & Management - Change Package
Lessons Learnt • We learnt the importance of keeping our aim in sight to maintain focus. • The importance of reliability to ensure sustainability – this takes time but ensures a stronger change package. • The importance of “champions” to drive a new concept on the ward. • The importance of staff consultation in the improvement of resources. • Implementation of any concept needs to be flexible to allow sustainability in all clinical areas.