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A multifaceted approach to prevention of delirium on intensive care
Delirium is a frequent complication of critical illness with an increased risk of death which is difficult to treat effectively. We describe a seven year quality improvement programme that aimed to reduce rates of delirium on intensive care (ICU). We completed two PDSA programmes with a number of ch...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
British Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693040/ https://www.ncbi.nlm.nih.gov/pubmed/26734390 http://dx.doi.org/10.1136/bmjquality.u209656.w4000 |
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author | Hanison, James Conway, Daniel |
author_facet | Hanison, James Conway, Daniel |
author_sort | Hanison, James |
collection | PubMed |
description | Delirium is a frequent complication of critical illness with an increased risk of death which is difficult to treat effectively. We describe a seven year quality improvement programme that aimed to reduce rates of delirium on intensive care (ICU). We completed two PDSA programmes with a number of changes including alterations to sedation practice and environmental changes to the ICU itself. Rates of delirium reduced from 70% to 44% after the first cycle of change. Rates of delirium were further reduced to 29% after the second cycle of change. The rates are now lower than predicted by the validated prediction tool PRE-DELIRIC. This project demonstrates that a multifaceted approach to prevention of delirium on ICU can deliver sustained reductions in rates of delirium. The impact of the second cycle of change was less than the first, suggesting that further reductions may prove more challenging. |
format | Online Article Text |
id | pubmed-4693040 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | British Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-46930402016-01-05 A multifaceted approach to prevention of delirium on intensive care Hanison, James Conway, Daniel BMJ Qual Improv Rep BMJ Quality Improvement Programme Delirium is a frequent complication of critical illness with an increased risk of death which is difficult to treat effectively. We describe a seven year quality improvement programme that aimed to reduce rates of delirium on intensive care (ICU). We completed two PDSA programmes with a number of changes including alterations to sedation practice and environmental changes to the ICU itself. Rates of delirium reduced from 70% to 44% after the first cycle of change. Rates of delirium were further reduced to 29% after the second cycle of change. The rates are now lower than predicted by the validated prediction tool PRE-DELIRIC. This project demonstrates that a multifaceted approach to prevention of delirium on ICU can deliver sustained reductions in rates of delirium. The impact of the second cycle of change was less than the first, suggesting that further reductions may prove more challenging. British Publishing Group 2015-09-11 /pmc/articles/PMC4693040/ /pubmed/26734390 http://dx.doi.org/10.1136/bmjquality.u209656.w4000 Text en © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode |
spellingShingle | BMJ Quality Improvement Programme Hanison, James Conway, Daniel A multifaceted approach to prevention of delirium on intensive care |
title | A multifaceted approach to prevention of delirium on intensive care |
title_full | A multifaceted approach to prevention of delirium on intensive care |
title_fullStr | A multifaceted approach to prevention of delirium on intensive care |
title_full_unstemmed | A multifaceted approach to prevention of delirium on intensive care |
title_short | A multifaceted approach to prevention of delirium on intensive care |
title_sort | multifaceted approach to prevention of delirium on intensive care |
topic | BMJ Quality Improvement Programme |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693040/ https://www.ncbi.nlm.nih.gov/pubmed/26734390 http://dx.doi.org/10.1136/bmjquality.u209656.w4000 |
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