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Abstract

Introduction: Delirium is common in intensive care units (ICUs) and is associated with higher mortality, increased length of stay (LOS), and long-term cognitive and functional decline. In this study we sought to evaluate the success of an educational program to enhance delirium knowledge and understanding for nurses and physicians at Beth Israel Medical Center, adapting previous research. Hypothesis: Through a multidisciplinary educational approach, nurses and physicians can be educated on the recognition, prevalence, associated risk factors and complications associated with delirium in the ICU. Methods: A cohort of all nurses and physicians in the Medical and Surgical ICUs of an 800-bed New York City hospital participated. Using a pre/post-implementation design, a validated delirium knowledge quiz was given before training to gauge baseline knowledge of delirium. Education on delirium prevalence, etiology, risk factors and outcomes, as well as tools to assess and manage delirium, were then provided in small groups using a standardized PowerPoint slideset. Alternate forms of the quiz were used. Knowledge test scores were compared using percentages and the Student’s T-test. Results: Our cohort consisted of 14 physicians and 54 nurses. 80% of nurses were female, 68% had ICU Certification, and 68% had more than 10 yrs ICU experience. Pre-/post-test comparisons showed improved overall test scores for physicians (57 % to 75%) 5.14 +/- 0.94 to 5.57 +/- 0.85. Nurses’ post-test scores showed statistically significant improvements (45% to 79%) 4.0 +/- 1.64 to 5.93 +/- 1.45 (t= 6.38, p= 0.0001) and those with <10 yrs experience had 10% higher scores on average. Greatest improvements were shown in items relating to recognition of delirium. Areas for targeted improvement were related to outcomes and risk factors. Conclusions: A standardized 20 minute educational program can improve ICU physicians’ and nurses’ knowledge of delirium in a large academic medical center. Ongoing studies will assess long-term knowledge gains and knowledge-based practice change, including improved inter-observer reliability in the recognition and assessment of delirium.