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Humber River Regional Hospital

Humber River Regional Hospital. Delirium CAM-ICU. Background. Humber River Regional Hospital is one of Canada’s largest regional acute care hospitals Serving a catchment area of more than 850,000 people in the Northwest GTA The hospital currently operates on 3 sites with a total of 549 beds

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Humber River Regional Hospital

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  1. Humber River Regional Hospital Delirium CAM-ICU

  2. Background • Humber River Regional Hospital is one of Canada’s largest regional acute care hospitals • Serving a catchment area of more than 850,000 people in the Northwest GTA • The hospital currently operates on 3 sites with a total of 549 beds • Our Critical Care Units are located at 2 of our sites with a total of 28 beds • We look to our patients to share their hospital experiences with us in guiding us towards developing plans for success and improvement across the organization

  3. Aim • Identify Critical Care patients at risk of delirium with the use of CAM-ICU at both of our sites Goals/Objectives: • To implement delirium protocol in the ICU by December 2012 • To assess the impact of the protocol on current self extubation rates • Early identification of patients with delirium

  4. Team Members • Yemi Adebayo- Manager Finch ICU • Sarah Morris- CPL Church ICU • Claudia Mitchell- Manager Church ICU • Dr Terry Cooligan- Intensivist • MojganKhoravis-Babadi- Pharmacist • Paula Abramczyk-Cazes- Social Worker • Jinhee Oh- Pharmacist • Cecile Marville- Williams- Sponsor

  5. Results • Compliance with use of the Richmond Agitation Sedation Score in documentation • Identifying and reporting symptoms of delirium in daily rounds

  6. Changes Tested • Started to look at incidence of delirium among patients during daily rounds • Compliance to Richmond Agitation Sedation Scale (RASS) • Roll out of our ICU daily rounds sheet which includes daily assessment of delirium • Staff’s understanding of the tool-pocket cards • Incorporated early mobilization in daily goal

  7. Lessons Learned • Need for staff to understand the causes of delirium, including medications (eg Benzodiazepines) and other predisposing factors • Need for education for appropriate use of CAM-ICU • To develop delirium screen in meditech to improve documentation • Include delirium screening into our safety crosses

  8. Next Steps • Testing the tool • Audit incidence of delirium-numerator/denominator • Auditing CAM compliance • Ongoing huddle on the risk factors of delirium • Head of bed display

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