Reducing ICU Delirium Through Implementation of the ICU Liberation Bundle

Purpose The purpose of this project was to evaluate whether identifying delirium through the Confusion Assessment Method for the ICU (CAM-ICU) assessment followed by treating delirium positive patients with the ICU Liberation Bundle reduced ventilator days or length of ICU stay and increased nursing satisfaction. Background ICU delirium is an acute state of confusion that affects up to 80% of ICU patients and increases morbidity and mortality. Decreasing the occurrence of delirium increases patient survivability and improves patient care (Society of Critical Care Medicine, 2023). There is currently no gold standard for managing and treating ICU delirium. Methodology This project tracked the management of ventilated patients from ICU admission to discharge, including whether the CAM-ICU assessment was documented, if the patient screened positive for delirium, and whether the bundle was implemented. This project also examined Likert survey results from ICU nurses about delirium management and best practice. Results The results of the project showed a notable increase in the frequency and consistency of CAM-ICU assessments by nursing staff as well as early implementation of the bundle. These changes were associated with a decrease in ventilator days among delirium positive patients. Additionally, surveys indicated an increase in nursing satisfaction. Implications The implications of this QI project suggest that the ICU Liberation Bundle is a feasible approach for treating patients with delirium and could have a broader application for all patients recovering from the intensive care unit.