Increasing Delirium Screening Rates in the Children's Hospital Colorado PICU

Monday, March 23, 2026

10:15 AM - 11:15 AM Central Time

Location: Connections Central - RST 10

Matthew Baker, n/a

Children's Hospital Colorado, Colorado

Disclosure(s): No relevant financial relationship(s) to disclose.
AG

Anneliese Grewing, DO, MS

Baylor College of Medicine

Disclosure(s): No relevant financial relationship(s) to disclose.
PN

Pablo Napky Raudales, MD, FAAP

Assistant Professor
Children's Hospital Colorado

Disclosure information not submitted.
KW

Kelli Welter, N/A

PharmD
Children's Hospital Colorado

Disclosure information not submitted.
SS

Sara Shankman, N/A

DNP
Children's Hospital Colorado

Disclosure information not submitted.
AH

Anne Hanz, N/A

DNP
Children's Hospital Colorado

Disclosure information not submitted.
SC

Shanda Cahoy, N/A

RN
Children's Hospital Colorado

Disclosure information not submitted.
HH

Heather Hammett, N/A

RN
Children's Hospital Colorado

Disclosure information not submitted.
SR

Sara Romme, N/A

RN
Children's Hospital Colorado

Disclosure information not submitted.
SG

Sara Galt, N/A

RN
Children's Hospital Colorado

Disclosure information not submitted.
ED

Elizabeth Diaz, N/A

RN
Children's Hospital Colorado

Disclosure information not submitted.
SC

Sherrill Caprarola, N/A

MD
Children's Hospital Colorado; University of Colorado

Disclosure information not submitted.
ML

Michele Loi, N/A

MD
Children's Hospital Colorado; University of Colorado

Disclosure information not submitted.

Introduction: Delirium is characterized by acute impairment of cognition and awareness and is highly prevalent among critically ill patients. Risk factors for delirium in the pediatric intensive care unit (PICU) are numerous and early identification is crucial to mitigating detrimental consequences. Standardized delirium screening using a validated tool, such as the Cornell Assessment of Pediatric Delirium (CAPD), can reduce the impact delirium has on patients, however, the Children's Hospital Colorado (CHCO) PICU has poor adherence to delirium screening. This project aimed to increase adherence to CAPD scoring of patients admitted to the CHCO PICU to allow for earlier delirium identification.

Methods: A pre-intervention survey was distributed to nurses in the CHCO PICU to identify barriers surrounding CAPD scoring of patients. Based off this survey, interventions were implemented including 1) electronic medical record-based reminders, 2) multi-disciplinary education, and 3) modifications to departmental delirium protocols. A post-intervention survey assessed the impact of interventions on nursing workload and patient care. Data collection included survey responses and pre- and post-intervention CAPD screening compliance and CAPD positivity rates amongst patients admitted to the CHCO PICU from April 2024 through April 2025.

Results: A pre-intervention nursing survey assessing barriers to CAPD scoring demonstrated lack of understanding of CAPD score validity (68.8% of respondents) and lack of reminders to perform CAPD scoring (40.6% of respondents) which informed intervention development. Following intervention implementation, CAPD scoring compliance increased from a baseline of 35.3% (Apr ’24-July ’24) to 74.5% (Jan ’25-Apr ’25). Delirium screening positivity rates (CAPD score >8) decreased from 56.8% (Apr ’24-July ’24) to 42.0% (Jan ’25-Apr ’25). The post-intervention impact survey of nurses demonstrated that the project had a neutral or positive impact on daily workflow and patient care (100% of respondents).

Conclusions: This project improved delirium screening compliance in a large pediatric ICU using a bundled intervention approach without negatively impacting nurse workflow or patient care. Future work will focus on sustainability and improving the use of delirium prevention and treatment measures.