Moving from tool‐based research to system‐wide change

Delirium is a serious condition characterized by alterations of consciousness, attention, and perception. Misconceptions and lack of understanding on early identification of delirium leads to many individuals lacking immediate intervention required to prevent life-threatening consequences. Education on early identification of delirium should extend beyond health care professionals and reach into the homes and community where individuals at risk for delirium reside.

Services provided through my facility include a crisis mobile team responding to individuals with behavioral health issues. Not only does this special crisis team assess individuals for mental and suicidal tendencies, they also coordinate the appropriate treatment and level of care required. Some characteristics presented by delirium include confusion, anxiety, incoherent speech and hallucinations. Awareness of delirium signs by this crisis team is essential for accurate diagnosis and medical treatment intervention. The internal method for dissemination of the evidence-based change proposal for the crisis team would include a PowerPoint presentation outlining the signs of delirium along with a pocket card for quick access to be carried when the team is responding to a call.

An external method of communication includes an organization providing services for the elderly in my community. Pima Council on Aging has expanded training for CNAs, certified caregivers, assisted living managers and direct care workers in the community through their Caregiver Training Institute (CGTI). Research has determined when family members or direct care providers are educated on the signs of delirium, they are able to intervene quickly and provide information for the hospital should that member be admitted. The Family Confusion Assessment Method (FAM‐CAM} consists of 11 items that characterize changes in attention, speech, arousal, and orientation and is another method for delirium education (Kennedy, Hwang & Han, 2020). The training on the FAM-CAM method for identifying delirium would be in the format of an in-house workshop at the Pima Council on Aging led by a RN.

The methods between external and internal dissemination vary for the change proposal; however, the message is consistent in providing education for early identification of delirium. Early detection and treatment of delirium can prevent acceleration of cognitive and functional decline.