Background: Delirium affects more than half of elderly hospitalized adults, with associated morbidity, mortality, increased length of hospital stay, higher than average hosptial costs, and poor outcomes. Despite the prevalence of delirium and associated hardships, delirium goes underdiagnosed, nationally. With the ever increasing aging population, hospitals and healthcare providers are challenged with this epidemiologic issue, requiring an evidence based approach to enhance the health and well-being of the older adults and preventing detrimental outcomes. EBP Framework: the Normalization Process Theory (NPT) and the Steven’s Star Model of Knowledge Transformation (SSMKT) model were selected to guide the implementation of the Short Confusion Assessment Method (CAM-S) tool in the acute care setting. The purpose of the project was to implement this CAM-S tool to answer the clinical question, “Will implementing the CAM-S instrument, on the orthopedic/neuology unit, among all nurses caring for hip fracture patients, as compared to no instrument, increase the number of patients detected with delirium in 30 days? Secondary data points included pre/post tool implementation length of stay (LOS), fall rates, and admission to skills nursing facility (SNF). Methods: Pre-intervention information established nurse knowledge/attitude disconnect regarding delirium and a poor geriatric care environment. The goal of the project was to evaluate the efficacy of implementing a delirium screening tool compared to no screening tool, in identifying more geriatric hip fracture patients with delirium, consistently and earlier. Post tool implementation, evaluated over 30 and 60-days, appraised the following measurements: hip fractures, 65 and older, incidence of delirium, falls, average LOS, discharge to SNF, CAM-S assessment used, CAM-S assessment score. Additionally, post tests and surveys were used to evaluate nurses’ knowledge of delirium and CAM-S’ feasibility of use. Finding/Results: The results of this project demonstrated an increase in delirium diagnoses and decreases in discharges to SNF and fall rates among all hip fracture patients, 65 and older. Post tool survey and test demonstrated nurses found the tool easy to use and recommended it for further use; however, further education on delirium symptoms need to be employed to enhance CAM-S use knowledge and interrater reliability. Conclusion/Recommendation: Delirium is a common and serious acute neuropsychiatric syndrome with core features of inattention and global cognitive dysfunction. If detection is delayed, the trajectory of the condition is detrimental. Implementing the CAM-S delirium tool helps nurses identify delirium sooner than without a tool proving profound benefits towards timely diagnosis of an interventions for delirium, preventing further devastation.
