Date of Award

Spring 3-31-2021

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Dr. Jennifer Mensik PHD, RN

Second Advisor

Dr. Karen Gilbert DNP, NS, RN, CDP

Abstract

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and involvement in, care-planning within 2 months?

Evidence: Overwhelming evidence exists supporting the effectiveness of a non-pharmacological, multicomponent strategy for prevention of delirium in the healthcare setting, to include family involvement.

Intervention: To support family involvement in delirium prevention should a hospitalization occur, the American Geriatrics Society CoCare: Help Program Delirium Prevention Amidst COVID-19 Toolkit was offered to caregivers at an organization that provides support services to families living with Alzheimer’s.

Outcome: There was a statistically significant improvement in caregivers’ perceptions of, and confidence in, involvement in care after having received the Toolkit, as measured by 3 pre/post survey M-PICS/I-PICS questions (n=27, p=.010; p=.017; p=.35). Caregiver intent to use the toolkit to become more involved in care to prevent delirium in acute care situations was very often to always (76%). Anecdotal feedback suggested that hospitals should look at policies and practices that ensure patients and families feel free to advocate, and work to eliminate fear of repercussion.

Conclusion: In the age of COVID-19, it is vital that more of these such efforts by healthcare professionals ensue to protect this population from a worsening crisis, despite the many challenges they themselves face.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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