Early recognition of delirium in trauma patients.

OBJECTIVE

Evaluate change in practice and beliefs regarding delirium among nurses, pharmacists, respiratory therapists and physicians in a trauma intensive care unit.

METHODOLOGY/DESIGN/SETTING: Descriptive pre and post-design at a Level One Trauma Center. Education on causes of delirium, risk factors, strategies to prevent delirium and routine screening.

OUTCOME MEASURES

Change in practice and beliefs regarding delirium.

RESULTS

McNemars test measured the differences between pre- and post-questionnaires comparing the proportion of staff changed their responses in one direction to those who went in the opposite direction. Changes in "Delirium is largely preventable", were statistically significant (p=0.035). Haldol was the medication of choice for treating delirium, with an increase in use (p=0.062) post-intervention. The majority of participants believed a high percentage of patients experience delirium in a trauma intensive care. The two most frequent medical complications associated with delirium pre-questionnaire was over sedation 8 (22%) and falls 9 (24%) and in post-questionnaire, over sedation 12 (26%) and falls 13 (28%).

CONCLUSIONS

An educational intervention emphasising the importance of screening for delirium, risk factors for delirium and approaches to decrease the incidence of delirium can improve identifying and correctly treating delirium in a critical care setting. An educational program had concrete results in respondents' knowledge about delirium.