Pathways to Improve Delirium Screening

Introduction: The purpose of this study was to investigate the trauma community’s use of the CAM scoring for delirium, and what shortfalls they believe it has in practice. Additionally, we wanted to discover what can be done to improve delirium care.


Methods: A ten-question mixed-methods survey was sent to the members of the Society of Trauma Nurses via Email listserv. The survey included two open-response questions, allowing three responses for each question, and eight multiple-choice questions about delirium and delirium scoring.


Results: There were 130 respondents who completed the survey. The majority (42.5%%) are using CAM-B for scoring delirium, however, it was shocking that we discovered 35% indicated currently not using any scoring for delirium. Sleep/wake cycle bundle was reported as the most utilized intervention with CAM-positive patients. Mandatory screening was the most suggested change for improvement of delirium management.


Conclusions: A significant amount (35%) of our participants were not using any screening tool for delirium. Education of providers and nurses of the importance of CAM scoring as well as improving the utilization of the CAM score across all areas of inpatient care was indicated as much needed by participants. Those surveyed did not think that facilities had protocolized interventions when a patient was CAM positive, and also they expressed frustration with using the tool screening patients with traumatic brain injury and dementia. This is a potential practice improvement area to improve patient outcomes. The new unifying definition of delirium is a one of the many ways we are improving care for these patients, however this study indicated that additional research is needed to discover the best ways to educate nurses and providers on the importance of delirium and utilizing EMR communication now that the platform has become more advanced.