Date of Doctor of Nursing Practice Project Completion

Spring 5-31-2028

Faculty Advisor

Dr. Ramaswamy, Padmavathy

Abstract

Purpose:  To evaluate the effectiveness of a nurse-led, family caregiver–integrated delirium prevention protocol in improving bCAM screening compliance and caregiver confidence among hospitalized older adults in an Acute Care for the Elderly (ACE) unit.

Background; Delirium is a common but preventable complication in hospitalized older adults. Baseline assessments on the ACE Unit identified inconsistent bCAM screening and limited caregiver involvement. This quality improvement (QI) project aimed to improve early recognition through routine nurse screening and caregiver education to improve early delirium recognition and prevention.

Methodology: 12-week QI project using three PDSA cycles implemented nurse bCAM education, caregiver education, visual reminders, and audit feedback. Daily chart audits and pre- and post-intervention caregiver surveys measured outcomes, which were analyzed using descriptive statistics. Key limitations included implementation on a single unit, float nurse variability, caregiver availability, and the absence of a comparison group.

Results: Following implementation, 15 family/caregivers completed both the pre- and post-intervention surveys. Nurse compliance with bCAM screening increased from 50% at baseline to 91% after the intervention. Caregiver confidence also improved from 27% before the intervention to 72% after education. The findings suggest that caregiver education and daily bCAM screening can improve delirium recognition and prevention.

Implications: This project demonstrated that integrating routine bCAM screening with caregiver education improved nurse compliance and caregiver confidence in delirium prevention. Despite challenges related to float nurse participation, caregiver availability, and early patient discharge, reinforcement strategies and leadership support helped sustain implementation. These findings support incorporating structured delirium screening and caregiver education into routine practice.

Keywords

Older adults, delirium, acute confusion, delirium symptoms, family involvement, family engagement, caregiver involvement, Nurses, caregiver education, delirium prevention

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