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Timmins and District Hospital Critical Care Unit

Timmins and District Hospital Critical Care Unit. Delirium Collaborative November 2012. Background. 6 bed Critical Care Unit with one over-flow bed Mix of medical and surgical patients with Sudbury as our main referral hospital

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Timmins and District Hospital Critical Care Unit

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  1. Timmins and District HospitalCritical Care Unit Delirium Collaborative November 2012

  2. Background • 6 bed Critical Care Unit with one over-flow bed • Mix of medical and surgical patients with Sudbury as our main referral hospital • One part-time educator and rotating charge between the 2-3 staff RN’s on each shift • Locum internists on one week of call and only a few return regularly • 3 general surgeons with frequent locum coverage

  3. Aim • Implement a screening process within 6 months • Implement standardized interventions to manage delirium within 12 months • Staff educated on delirium awareness and prevention and poorer patient outcomes • Staff actively participate in screening for delirium and participate in managing symptoms of delirium within 6 months

  4. Team Members • Jennifer Plant, Quality and Performance Improvement Manager • Trevor Morden, CCU Manager • Clarice Watt, Educator for CCU • Dr. Voogjarv, Medical Director • Ad hoc: CCU RN, Pharmacist, RRT, Physician Assist, Physiotherapist and Social Worker

  5. Results • ICDSC picked as the tool we will use at TDH • All CCU nursing staff educated on delirium and screening process • Draft #8 of screening tool added to admission packages and available for staff • On-going audits of compliance being done and October result 78% (only our second month) • Self-directed learning package in draft form

  6. Changes Tested • Decision between use of ICDSC and CAM-ICU tool • Drafts of format of tool –now on draft 8

  7. Lessons Learned • Need in-put from staff • Continuous reinforcement required • Staff champions help to reinforce process • Conflicting priorities make moving forward slow at times • Staying positive so can complete the process over the next 6 months

  8. Next Steps • Solidify delirium screening as part each patient’s assessment each shift and continue to audit to achieve a 90% completion each shift • Complete a Mobility component • Complete ABCDE self-directed learning package • Revise protocol to include ABCDE • Pre-printed orders for Delirium positive patients

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