{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:52:05Z","timestamp":1790153525269,"version":"4.0.1"},"reference-count":38,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UCLA Clinical Translational Research Institute (CTSI)","award":["UL1TR001881"],"award-info":[{"award-number":["UL1TR001881"]}]},{"name":"UCLA Clinical Translational Research Institute (CTSI)","award":["K76AG059936"],"award-info":[{"award-number":["K76AG059936"]}]},{"name":"UCLA Clinical Translational Research Institute (CTSI)","award":["K76AG059936-05S1"],"award-info":[{"award-number":["K76AG059936-05S1"]}]},{"name":"Paul B. Beeson Emerging Leaders Career Development Award and Mentoring Supplement","award":["UL1TR001881"],"award-info":[{"award-number":["UL1TR001881"]}]},{"name":"Paul B. Beeson Emerging Leaders Career Development Award and Mentoring Supplement","award":["K76AG059936"],"award-info":[{"award-number":["K76AG059936"]}]},{"name":"Paul B. Beeson Emerging Leaders Career Development Award and Mentoring Supplement","award":["K76AG059936-05S1"],"award-info":[{"award-number":["K76AG059936-05S1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Although delirium is common during critical illness, standard-of-care detection and prevention practices in real-world intensive care unit (ICU) settings remain inconsistent, often due to a lack of provider education. Despite availability for over 20 years of validated delirium screening tools such as the Confusion Assessment Method in the ICU (CAM-ICU), feasible and rigorous educational efforts continue to be needed to address persistent delirium standard-of-care practice gaps. Methods: Spanning an 8-month quality improvement project period, our single-ICU interdisciplinary effort involved delivery of CAM-ICU pocket cards to bedside nurses, and lectures by experienced champions that included a live delirium detection demonstration using the CAM-ICU, and a comprehensive discussion of evidence-based delirium prevention strategies (e.g., benzodiazepine avoidance). Subsequent engagement by health system leadership motivated the development of an electronic health record dataset to evaluate unit-level outcomes, including CAM-ICU documentation and benzodiazepine administration. Results: Using a dataset that spanned 9 pre- and 37 post-project months and included 3612 patients, 4470 admissions, and 33,913 patient days, we observed that delirium education was followed by a dramatic rise in CAM-ICU documentation, from &lt;1% for daytime and nighttime shifts to peaks of 73% and 71%, respectively (p &lt; 0.0001 for trend), and a fall in the proportion of mechanically ventilated patients ever receiving benzodiazepine infusions (69% to 41%; p &lt; 0.0001). Conclusions: An interdisciplinary delirium project comprising rigorous lectures on standard-of-care practices can yield significant improvements in documentation and sedative administration. This approach can help ICUs jumpstart efforts to build awareness and address longstanding gaps in standard-of-care delirium practices.<\/jats:p>","DOI":"10.3390\/nursrep15010006","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T14:21:12Z","timestamp":1735654872000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Delirium Management Quality Improvement Project to Improve Awareness and Screening in a Medical ICU"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-0168","authenticated-orcid":false,"given":"Hirsh","family":"Makhija","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Digrande","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Awan","sequence":"additional","affiliation":[{"name":"Pulmonary Section, Medicine Service, VA Medical Center, Washington, DC 20422, USA"},{"name":"Department of Medicine, George Washington University, Washington, DC 20052, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-7435","authenticated-orcid":false,"given":"Russell G.","family":"Buhr","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA"},{"name":"Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research & Development, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajan","family":"Saggar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, Ronald Reagan UCLA Hospital, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainbow","family":"Tarumoto","sequence":"additional","affiliation":[{"name":"Division of Trauma, Surgical Critical Care and Acute Care Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6800-4222","authenticated-orcid":false,"given":"Janelle M.","family":"Fine","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9509-1827","authenticated-orcid":false,"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale M.","family":"Needham","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA"},{"name":"School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0849-3391","authenticated-orcid":false,"given":"Jennifer L.","family":"Martin","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, CA 90073, USA"},{"name":"Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-6229","authenticated-orcid":false,"given":"Biren B.","family":"Kamdar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1055\/s-0040-1710572","article-title":"Prevention and Management of Delirium in the Intensive Care Unit","volume":"42","author":"Mart","year":"2021","journal-title":"Semin. 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