Military Service Members and Emergence Delirium Screening: An Evidence-Based Practice Project

Abstract

Emergence delirium (ED) is a postoperative phenomenon characterized by agitation, confusion, and violent physical or verbal behavior that can occur after general anesthesia. Preoperative identification of patients at risk for ED may allow providers to take steps to minimize the incidence or severity of ED. Because no formal tool currently exists, the purpose of this project was to develop and evaluate a screening tool based on available evidence of ED risk factors. This quality improvement project used a preimplementation and postimplementation design. One hundred consecutive adult patient charts were reviewed 2months before implementation of the project questionnaire. These data were used to confirm preimplementation screening rates. Postimplementation, prospective data were gathered to test this newly developed assessment tool for usefulness in the clinical setting. The use of this focused screening tool significantly increased preoperative identification of patients at risk for ED compared with the preimplementation preoperative screening routine. Identification rates for at-risk patients rose from 5% to 21%-22.5% using this tool. This project demonstrated that the use of a focused tool to identify risk factors for ED could significantly increase actual identification rates for at-risk patients in the clinical setting.