Nurse-Driven Delirium Protocol

Grant Application

Erin Flanagan, MSN, UPMC Mercy

Proposed Innovation

Delirium — a sudden onset of confusion — is a common condition in hospitalized elderly patients. But it is a preventable and reverseable condition, if identified and treated early.

This project builds on an earlier Beckwith project that resulted in the creation of a nurse-driven delirium protocol for evaluating and caring for patients. Data collected during the initial project will now be used to fine tune guidelines to provide better care for at-risk patients and create a streamlined protocol for use by nurses and physicians in other acute care departments.

Improvements in Action

A clearly defined process will be established to guide the early identification, intervention, and treatment of patients at highest risk for delirium. To ensure consistency of care, a formal educational packet will be developed for use in training.

The main goal is to roll out use of a standardized nurse-driven delirium protocol to other departments so more at-risk patients can be flagged for treatment.

Intended Outcomes

Early identification of delirium already has shown great results, including less use of pain and delirium medications, fewer discharges to a skilled facility, significant reductions in 30-day readmissions, and more palliative consults. Having a strong, easy-to-use protocol to guide treatment will help to ensure more patients receive the treatment they need to prevent or reverse delirium.