Journal of nursing care quality
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Routine screening of mechanically ventilated patients for delirium is essential for prompt recognition and management; however, this represents a change in practice. Rogers' Diffusion of Innovations Theory can be useful as a strategy to facilitate adoption of a practice change. This case study describes the effectiveness of identifying barriers to a change in practice and developing strategies, specific to Rogers' innovation decision process, for implementing the Confusion Assessment Method for the intensive care unit.
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Delirium is an acute state of confusion that is often seen in older patients after major orthopedic surgical procedures. It is associated with increased costs of care, morbidity, delayed functional recovery, and prolonged hospital stay. Identification of predictive risk factors, early diagnosis and treatment, and implementation of environmental controls can minimize the impact of postoperative delirium. This project measured pre- and post intervention compliance with best practice in the prevention and management of postoperative delirium.
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Awareness for patient safety led a team to develop an electronic handoff communication tool for noncomplicated routine patients. The structure of SBAR (situation, background, assessment, and recommendation) was used when transferring patients to and from the progressive care unit and cardiac laboratories. The electronic SBAR gave staff a reliable and standard way to provide a patient handoff.