{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:28:51Z","timestamp":1793622531183,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Delirium affects up to 80% of adult intensive care unit (ICU) patients, resulting in a significant impact on clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This evidence implementation project evaluated and improved adherence to best practice guidelines for delirium screening and assessment in a specialized ICU setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This project used the JBI Evidence Implementation Framework and was conducted in a 10-bed adult neurological ICU in S\u00e3o Paulo, Brazil. Compliance was assessed across seven best practice audit criteria measured at baseline (n\u200a=\u200a27) and at follow-up (n\u200a=\u200a27). Using JBI's Getting Research into Practice (GRiP) analysis, two primary barriers were identified: nurse knowledge deficits and operational time constraints due to documentation complexity. To address these barriers, micro-learning sessions were conducted using gamification, quick-access electronic health record templates, and visual huddle reminders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The follow-up audit demonstrated increased compliance across five criteria: daily observation, formal assessment (CAM-ICU), nurse training, clinical prioritization, and complete documentation. Compliance remained unchanged for two criteria: initial risk screening upon ICU admission and immediate observation following a positive screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Strategic implementation using gamified education and streamlined workflows successfully bridged knowledge and operational gaps in a high-acuity neurological ICU. Combining active-learning strategies with workflow simplification proved essential for driving sustainable improvements in clinical delirium assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Spanish abstract:<\/jats:title>\n                    <jats:p>https:\/\/links.lww.com\/IJEBH\/A723<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/xeb.0000000000000665","type":"journal-article","created":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:00:58Z","timestamp":1793620858000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Screening and assessment of delirium in adult intensive care unit patients: a best practice implementation project"],"prefix":"10.1097","author":[{"given":"Ludmila Calefi","family":"Facchin","sequence":"first","affiliation":[{"name":"Sociedade Beneficente de Senhoras Hospital S\u00edrio Liban\u00eas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6174-0155","authenticated-orcid":false,"given":"Isabela","family":"Gomes Musa dos Santos","sequence":"additional","affiliation":[{"name":"Sociedade Beneficente de Senhoras Hospital S\u00edrio Liban\u00eas, S\u00e3o Paulo, Brazil"},{"name":"Escola de Enfermagem de Ribeir\u00e3o Preto da Universidade de S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Bucci","family":"Sanches","sequence":"additional","affiliation":[{"name":"Sociedade Beneficente de Senhoras Hospital S\u00edrio Liban\u00eas, S\u00e3o Paulo, Brazil"},{"name":"Escola de Enfermagem da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa de Oliveira Silva","family":"Bertacchini","sequence":"additional","affiliation":[{"name":"JBI Brazilian Centre for Evidence-Based Health Care, Escola de Enfermagem da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"issue":"15","key":"R1-20261102","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1056\/NEJMcp1605501","article-title":"Delirium in hospitalized older adults","volume":"377","author":"Marcantonio","year":"2017","journal-title":"N Engl J Med"},{"issue":"2","key":"R2-20261102","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1055\/s-2001-13826","article-title":"Delirium in the intensive care unit: an under-recognized syndrome of organ dysfunction","volume":"22","author":"Ely","year":"2001","journal-title":"Semin Respir Crit Care Med"},{"issue":"4","key":"R3-20261102","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/j.chest.2021.06.002","article-title":"How we prevent and treat delirium in the ICU","volume":"160","author":"Palakshappa","year":"2021","journal-title":"Chest"},{"issue":"9","key":"R4-20261102","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","author":"Devlin","year":"2018","journal-title":"Crit Care Med"},{"key":"R5-20261102","doi-asserted-by":"crossref","first-page":"104410","DOI":"10.1016\/j.ijnurstu.2022.104410","article-title":"The effect of the ABCDE\/ABCDEF bundle on delirium, functional outcomes, and quality of life in critically ill patients: a systematic review and meta-analysis","volume":"138","author":"Sosnowski","year":"2023","journal-title":"Int J Nurs Stud"},{"issue":"3","key":"R6-20261102","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/XEB.0000000000000470","article-title":"Adherence to optimal delirium management practices in intensive care units in Brazil: a nationwide survey","volume":"23","author":"Bispo","year":"2025","journal-title":"JBI Evid Implement"},{"issue":"1","key":"R7-20261102","first-page":"e64484","article-title":"[Training nurses in the use of a delirium assessment tool]","volume":"38","author":"da Silva Souza","year":"2017","journal-title":"Rev Ga\u00facha Enferm"},{"issue":"11","key":"R8-20261102","first-page":"1917","article-title":"The validity and reliability of the Portuguese version of three tools used to diagnose delirium in critically ill patients","volume":"66","author":"Gusmao-Flores","year":"2011","journal-title":"Clinics"},{"key":"R9-20261102","first-page":"e03344","article-title":"[Translating knowledge: JBI's expertise]","volume":"52","author":"Pu\u0308schel","year":"2018","journal-title":"Rev Esc Enferm USP"},{"issue":"1","key":"R10-20261102","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/XEB.0000000000000155","article-title":"The updated Joanna Briggs Institute Model of Evidence-Based Healthcare","volume":"17","author":"Jordan","year":"2019","journal-title":"Int J Evid Based Healthc"},{"issue":"1","key":"R12-20261102","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/XEB.0000000000000361","article-title":"JBI's approach to evidence implementation: a 7-phase process model to support and guide getting evidence into practice","volume":"21","author":"Porritt","year":"2023","journal-title":"JBI Evid Implement"},{"key":"R13-20261102","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s12912-021-00579-2","article-title":"Lifelong learning and nurses\u2019 continuing professional development: a metasynthesis of the literature","volume":"20","author":"Mlambo","year":"2021","journal-title":"BMC Nurs"},{"issue":"6","key":"R14-20261102","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.jen.2023.06.004","article-title":"Escape the monotony: gamification enhances nursing education","volume":"49","author":"Seymour","year":"2023","journal-title":"J Emerg Nurs"},{"issue":"3","key":"R15-20261102","doi-asserted-by":"crossref","first-page":"e12994","DOI":"10.2196\/12994","article-title":"Serious gaming and gamification education in health professions: systematic review","volume":"21","author":"Gentry","year":"2019","journal-title":"J Med Internet Res"},{"issue":"3","key":"R16-20261102","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1055\/a-1868-6431","article-title":"Implementing best practices to redesign workflow and optimize nursing documentation in the electronic health record","volume":"13","author":"Lindsay","year":"2022","journal-title":"Appl Clin Inform"},{"key":"R17-20261102","doi-asserted-by":"crossref","first-page":"e38144","DOI":"10.2196\/38144","article-title":"The impact of electronic health record interoperability on safety and quality of care in high-income countries: systematic review","volume":"24","author":"Li","year":"2022","journal-title":"J Med Internet Res"},{"key":"R18-20261102","doi-asserted-by":"crossref","first-page":"111566","DOI":"10.1016\/j.jclinane.2024.111566","article-title":"Effectiveness of a delirium risk assessment and multidisciplinary care approach in reducing delirium incidence among surgical intensive care unit patients: a retrospective pre-post intervention study","volume":"98","author":"Hsiao","year":"2024","journal-title":"J Clin Anesth"}],"container-title":["JBI Evidence Implementation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/XEB.0000000000000665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:01:01Z","timestamp":1793620861000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/XEB.0000000000000665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1097\/xeb.0000000000000665","relation":{},"ISSN":["2691-3321"],"issn-type":[{"value":"2691-3321","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]}}}