Date of this Version
continuous 1:1 observation, delirium, nursing knowledge
BACKGROUND: Nursing leadership identified that Certified Nursing Assistants (CNAs) and Registered Nurses (RNs) on the Acute Care for Elders (ACE) unit lacked delirium knowledge. Patients were being placed on continuous 1:1 observation without proper delirium assessment which the CNO identified as an opportunity to improve resource utilization.
METHODS: A quality improvement project was conducted on the ACE unit at Penn Presbyterian Medical Center (PPMC). The CNAs and RNs completed a delirium knowledge survey prior to and after viewing an evidence-based dynamic education module based on the Hospital Elder Life Program (HELP) protocols. Pre- and post-survey mean scores were compared. Continuous 1:1 observation utilization was analyzed two months prior to and two months post-implementation to determine if the education impacted continuous 1:1 observation utilization.
RESULTS: 17 CNAs and 34 RNs completed the pre-survey. Mean pre-survey scores were: 11.76 (sd 1.92, range 7-15) for the CNAs and 13.5 (sd 2.11, range 9-17) for the RNs. Ten CNAs and 20 RNs completed the post-survey. The post-survey mean scores were: 13.5 (sd 2.68, range 9-16) for the CNAs and 14.7 (sd 1.76, range 11-18) for the RNs. Bi-weekly continuous 1:1 utilization decreased from 5.0 to 3.4 after implementation of the evidence-based dynamic education module.
CONCLUSION: Evidence based education on delirium prevention, identification, and interventions using the HELP protocols can improve CNA and RN knowledge and help reduce the financial strain on the health system by decreasing continuous 1:1 observation utilization.
Date Posted: 25 February 2022