P0078 / #1967: QUIET TIME: IMPACT OF AN ENVIRONMENTAL INTERVENTION ON NOISE AND DELIRIUM SCREENING AND SCORES IN THE PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: Pediatric delirium increases mortality, cost, and length of hospital stay, yet is inconsistently screened for in our academic Pediatric Intensive Care Unit (PICU) using the Cornell Assessment of Pediatric Delirium (CAPD). We evaluate the impact of an environmental intervention, Quiet Time, on PICU noise and CAPD screening and scores. Methods: Quiet Time was implemented daily from 1-3pm indefinitely with text reminders to all PICU clinical staff to dim lights and lower voices. Nurses were surveyed to evaluate perceived noise level and impact on patient health. Chart review was used to assess four day’s duration of CAPD screening frequency and prevalence of patients screening positive for delirium (score ≥9/32), one week before and one month after Quiet Time implementation. Results: Before Quiet Time implementation, nurses (n=21) rated noise somewhat loud (81%), neither loud/quiet (14%), or somewhat quiet (5%). Noise impact was rated extremely disruptive (33%) or somewhat disruptive (67%). Of 35 patients, 57% were CAPD screened, of which 17% screened positive for delirium. After implementation, nurses (n=16) rated noise level somewhat loud (19%), neither loud/quiet (37%), or somewhat quiet (44%). Noise impact was rated somewhat restful (25%), neither disruptive nor restful (31%), somewhat disruptive (38%), or extremely disruptive (6%). Of 32 patients, 69% were CAPD screened, of which 25% screened positive for delirium. Conclusions: After Quiet Time implementation, noise level and disruption decreased while prevalence of patients screening positive for delirium increased, possibly due to increased CAPD screening frequency. Our data suggest that Quiet Time promotes a quieter environment and increases delirium screening.