SHM Converge Scientific Abstract ePoster Gallery-Improving Delirium Identification, Prevention, and Management: A Pilot Protocol for Elderly Hospitalized Patients

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This pilot project at Lakeland Regional Health addresses the lack of a standardized delirium protocol outside the ICU for hospitalized older adults, a population at high risk for poor outcomes such as prolonged length of stay, falls, and long-term cognitive decline. The initiative aims to improve early identification, prevention, and management of delirium through a stepwise protocol.<br /><br />The project includes three phases:  <br />1. Daily delirium screening using the CAM Short assessment for patients over 50 on a pilot medical floor.  <br />2. Nursing-led nonpharmacologic interventions, including sleep hygiene, personal hygiene, mobility support, sensory support via the 3-2-1 protocol, use of visual/hearing aids, and pain control.  <br />3. A PowerPlan that allows physicians to order delirium-specific nursing interventions.<br /><br />Early implementation data from June and July 2025 showed that CAM-positive patients had consistently worse outcomes than CAM-negative patients. In June, 5.7% of 140 screened patients were CAM positive and had a much longer average hospital stay (27.1 vs. 6.6 days). Restraint use was substantially higher in CAM-positive patients. In July, 6.4% of 218 patients had at least one positive CAM result, again with longer length of stay (10.4 vs. 5.8 days), higher fall rates (7.1% vs. 1.0%), and greater restraint use. Medication use was similar between groups.<br /><br />Overall, the early findings reinforce delirium as a marker of increased risk and highlight the importance of structured screening and nonpharmacologic prevention strategies. Continued data collection over the next several months is expected to better evaluate the protocol’s impact on length of stay, falls, and adherence to mobilization practices.

Asset Subtitle

Daniela Carralero-Somoza

Meta Tag

Author List Anas Bizanti, Archa James, Daniela Carralero-Somoza, Danielle Madison, Graciela M. Luna, Jason Baluja, Lauren Martinez, Sophia Elortegui, Zachary Breslow, Zoya Khan

Category Innovations

Concept Delirium

Concept Clinical protocol

Concept Delirium screening

Concept Confusion Assessment Method Short

Concept Delirium detection

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health Medical Center

Presenting Author Daniela Carralero-Somoza

Track Quality Improvement

Keywords

delirium

older adults

hospitalized patients

CAM Short

screening protocol

nonpharmacologic interventions

length of stay

falls prevention

nursing interventions

Lakeland Regional Health

Delirium

Clinical protocol

Delirium screening

Confusion Assessment Method Short

Delirium detection