Prevention and Management of Postoperative Delirium in Adult Patients: a Best Practice Implementation Project

Overview

Journal Rev Esc Enferm USP

Specialties Medical Education
Nursing

Date 2025 Feb 25

PMID 39997608

Authors

Juliana Rizzo Gnatta

Sarha de Oliveira Goncalves Paes

Maria Fernanda de Oliveira Faria

Domingos Dias Cicarelli

Renata Veloso Silva Laurino

Lina Hamano

Vilanice Alves de Araujo Puschel

Vanessa de Brito Poveda

Affiliations

Soon will be listed here.

Abstract

Objective: To describe the process of implementing evidence-based best practices to improve the prevention and management of Postoperative Delirium in the Post-Anesthesia Care Unit.

Method: Report on an evidence implementation project applying the JBI based on the audit and feedback process, with a structured approach to identifying and managing barriers in accordance with recommended clinical practices. Medical records, electronic nursing record systems, and staff interviews were used to assess compliance rates.

Results: In the baseline audit, a zero compliance rate was found in most criteria in relation to the best evidence. Following this phase, interprofessional training was carried out, a validated tool was provided to identify patients at risk of delirium, and changes were made to the electronic nursing records system. In the first follow-up audit, there was an increase in the compliance rate in four of the nine criteria audited. Four criteria achieved 100% compliance in the second follow-up audit.

Conclusion: Best practices were implemented that contributed to improving the prevention and management of Postoperative Delirium. Subsequent to new training and re-auditing after one year, an increase in adherence to best practices was observed.

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