Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-6-2022

Graduate Advisor

Dr. Roxanne Reid - Chairperson

Committee

Dr. Roxanne Reid - Chairperson

Dr. Cathy Koetting

Dr. Jessica Mann

Abstract

Abstract

Problem: Pediatric delirium is highly prevalent in the intensive care setting, as much as seventy to eighty-seven percent. Kalvas & Harrison (2020) found that sixty-six percent of critically ill children in a pediatric intensive care unit suffered from a diagnosis of delirium. Delirium has been widely linked with increased costs, mortality, and length of stay.

Methods: The quality improvement (QI) project used a descriptive design to collect retrospective and prospective data before and after an individualized bedside education session was completed. The QI project used a purposive convenience sampling to assess the ability to accurately identify the presence of delirium and its sub-type among patients undergoing cardiac surgery in a pediatric cardiac intensive care unit (CICU).

Results: Descriptive statistics and Chi-square tests were ran and although there was not statistical significance between the identification of delirium and its sub-types, however there was a notable shift. A larger sample size may be necessary to show statistical significance.

Implications for practice: There should be continued education on the use of the Richmond Agitation Sedation Score (RASS) and Cornell Assessment of Pediatric Delirium (CAP-D), whether that be quarterly or annually. There should also be initial education on the RASS and CAP-D for newly hired staff. The RASS and CAP-D should continue to be used identify delirium and its sub-types accurately. Multiple Plan-Do-Study-Act (PDSA) cycles may be necessary to reach even greater compliance. One such PDSA cycle might include adding delirium specific rounding to practice.

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