Prevention and management of postoperative delirium in adult patients: a best practice implementation project.

Abstract

Objective: To describe the process of implementing evidence-based best practices to improve the prevention and management of Postoperative Delirium in the Post-Anesthesia Care Unit.

Method: Report on an evidence implementation project applying the JBI based on the audit and feedback process, with a structured approach to identifying and managing barriers in accordance with recommended clinical practices. Medical records, electronic nursing record systems, and staff interviews were used to assess compliance rates.

Results: In the baseline audit, a zero compliance rate was found in most criteria in relation to the best evidence. Following this phase, interprofessional training was carried out, a validated tool was provided to identify patients at risk of delirium, and changes were made to the electronic nursing records system. In the first follow-up audit, there was an increase in the compliance rate in four of the nine criteria audited. Four criteria achieved 100% compliance in the second follow-up audit.

Conclusion: Best practices were implemented that contributed to improving the prevention and management of Postoperative Delirium. Subsequent to new training and re-auditing after one year, an increase in adherence to best practices was observed.