Carol Droegemueller, Nursing, North Memorial Medical Center, Robbinsdale, MN, USA
An acute care unit team strategized how to increase the use of the NEECHAM confusion assessment tool. The goal for the staff was to have the staff complete a confusion assessment tool for each person aged 75 and over within 24 hours of admission to the unit. The purpose of this research is to describe and evaluate strategies to increase implementation for evidence-based practice. The sample includes staff on a 35 bed orthopedic unit in an urban hospital located in the Midwest. The intervention strategies included identifying possible barriers to use of the confusion assessment tool, making the confusion assessment tool more easily available, and reinforcing staff for use of the tool. Some specific strategies included: placing the assessment tool form on each patient’s clipboard with the admission paper work, giving hand-written notes to completers of the assessment, and team incentives as well as individual incentives for completing the assessment tool on a daily basis. The method of evaluation was to measure the use of the confusion assessment tool for all patients over 75 by daily, monthly, or quarterly audits. Every three months following the implementation of new strategies for success, an evaluation was completed. The data results of three consecutive quarterly evaluations will be shared. Early data (six months following the implementation phase) shows a significant increase from 56% rate of completing the admission NEECHAM assessment to 96%. Implementation of a best practice with the consistent use of an acute confusion bedside assessment tool on an acute orthopedic unit was enhanced through the review of barriers, staff education, positive reinforcement, advanced practice nursing involvement and sharing performance data.