Journal of Neurology and Neuroscience

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For an ICU without delirium: evaluation of the impact of an educational intervention

Patricia Mesa

In the Intensive Care Unit (ICU) the application of the Richmond Agitation Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), are not systematically implemented in the clinical practice. At Pasteur Hospital´s ICU, they were not applied until 2013.  In 2014-2015 the first prospective study on delirium in the ICU showed a low use and degree of compliance of the scales (RASS: 0.17 [DE 0.07], CAM-ICU: 0.20 [DE 0.11]). In 2016, educational workshops were implemented in the use of CAM-ICU to screen delirium. Evaluate the improvement in the application of RASS and CAM-ICU. Describe the incidence of delirium and related variables post educational interventions. Descriptive, prospective study of patients admitted to the Pasteur Hospital ICU between March 1 and May 31, 2017 Inclusion criteria: age ≥ 18, stay ≥ 24 hours. Training: dissemination of RASS and CAM-ICU, workshop and bedside mode.
Use of the tool: ratio of patients evaluated by RASS and CAM-ICU. Delirium was diagnosed with CAM-ICU positive, evaluating its incidence and related variables.
Training increased the use of the tools, being even lower than recommended. The incidence of delirium was 48%. We must continue educating.