Date Presented 04/03/2025
A quality improvement initiative that uses virtual learning content to increase interprofessional health care providers’ understanding and confidence with providing informed delirium care.
Primary Author and Speaker: Melissa M Williams
Additional Authors and Speakers: Jessica Asiello
BACKGROUND: Delirium is the most common neuropsychiatric disorder in the medical setting, however a lack of interprofessional education exists which perpetuates adverse outcomes. A quality improvement project was developed by an occupational therapist to enhance provider knowledge and self-efficacy surrounding delirium care.
DESIGN: A virtual six-month quality improvement initiative took place on a general medicine floor of a large teaching hospital. A convenience sample was utilized; all 40 nurses on the pilot unit were invited to participate. Virtual learning content included recorded mini lessons, monthly newsletters and a provider website with theoretical guidance from Adult Learning Theory and Social Cognitive Theory.
METHOD: Primary outcomes of provider knowledge and perceived self-efficacy related to delirium care were measured with a pre-post survey, using adapted versions of The Nurses Delirium Knowledge Questionnaire (Hare et al., 2008) and The Attitude Tool of Delirium (Papastavrou et al., 2019). Engagement with learning content was tracked, and a medical chart audit was performed to screen for delirium terms in clinical documentation.
RESULTS: Providers demonstrated gaps of knowledge in the pre and post survey. Providers reported comfort in providing delirium care, but responses varied for perceived severity of delirium. Engagement in learning content fluctuated, but overall rates were low. Documentation of delirium terms was low, however documentation including signs of delirium without identifying it as delirium was higher.
CONCLUSION: Delirium care is a crucial issue for acute care practice, and one that must be addressed by an interprofessional team. This quality improvement initiative was developed by an occupational therapist who utilized a holistic approach when creating learning content that is able to be transferable to a vast interprofessional team and highlights occupational therapist ability to spearhead education and collaboration.
References
Arachici, T.M.J., Pinto, V. (2021). Understanding the barriers in delirium care in an intensive care unit: A survey of knowledge, attitudes, and current practices among medical professionals working in intensive care units in teaching hospitals of Central Province, Sri Lanka. Indian Journal of Critical Care Medicine, 25(12), 1413–1420. https://doi.org/10.5005/jp-journals-10071-24040
Papaioannou, M., Papastavrou, E., Kouta, C., Tsangari, H., & Merkouris, A. (2023). Investigating nurses’ knowledge and attitudes about delirium in older persons: a cross-sectional study. BMC Nursing, 22(10). https://doi.org/10.1186/s12912-022-01158-9
Rieck, K. M., Pagali, S., Miller, D. M. (2020). Delirium in hospitalized older adults. Hospital Practice, 48(1), 3–16. https://doi.org/10.1080/21548331.2019.1709359
