NYSPFP HIIN: VAE/Delirium Prevention. Operationalizing the Pain, Agitation and Delirium Assessments
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1 NYSPFP HIIN: VAE/Delirium Prevention Operationalizing the Pain, Agitation and Delirium Assessments March 28,
2 Agenda Topic Welcome and Introductions A Guide for Success: Implementing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) VAE and Delirium Prevention Speaker NYSPFP Staff Westchester Medical Center Team Valhalla, NY Mohawk Valley Health System Team Utica, NY Hospital Questions and Discussion Hospital Participants Facilitated by NYSPFP Staff Tools and Resources/Next Steps NYSPFP Staff 2
3 NYSPFP Approach to VAE/Delirium Reduction
4 VAE/Delirium Goal and Approach Goal: To reduce ventilator-associated events (VAE) by 20% and the incidence of iatrogenic delirium in critical care patients. Hospitals will focus on spreading interventions to reduce VAE and delirium throughout critical care units. NYSPFP will support hospitals in implementing evidence based strategies including: o o Implementation of the ABCDEF Bundle VAE: o High Reliability in application of the VAP bundle o Implementing emerging interventions aimed at reducing VAE 4
5 Why VAE and Delirium Prevention Together?
6 ABCDEF Bundle Components
7 VAE/Delirium Measures for NYSPFP NYSPFP Measure Category Delirium Process Measure (All ICU patients included in prevalence study) Pain assessment utilization rate (Manual Collection) Suggested Tool(s): CPOT or BPS Delirium Process Agitation assessment utilization rate (Manual Collection) Suggested Tool(s): RASS or SAS Delirium Process Delirium assessment utilization rate (Manual Collection) Suggested Tool(s): CAM-ICU or ICDSC Delirium Outcome VAE Process VAE Outcome Prevalence rate of ICU patients meeting the diagnostic criteria for delirium as measured by a delirium assessment (Manual Collection) Ventilator Utilization Ratio VAE Rate per 1,000 Ventilator Days (NHSN) 7
8 PAD Assessment Tools 8
9 9 Operationalizing the Pain, Agitation and Delirium Assessments
10 Hospital Questions and Discussion NYSPFP Staff Hospital Participants 10
11 NYSPFP Delirium Data Entry, Tools and Resources
12 NYSPFP Website: Tools and Resources ctionprevention/vap/tools.aspx Additional Resources: IPRO VAE Master Project Plan PAD Assessment Tools Critical Care Pain Observation Tool Behavioral Pain Scale Richmond Agitation-Sedation Scale Sedation Agitation Scale Complete CAM-ICU Training Manual Intensive Care Delirium Screening Checklist ABCDEF Bundle Action Planning Tool 12
13 NYSPFP PAD Process Measure Tracking Tool
14 NYSPFP Delirium Data Entry 14
15 NYSPFP Delirium Measure Data Entry 15
16 NYSPFP Delirium Measure Data Entry Monthly drop down Hit save 16
17 ABCDEF Bundle Action Planning Tool
18 Critical Care Team Education & Support Targeted education and tools for Critical Care Unit Staff: o VAE/Delirium Prevention o Daily Safety Checks o Sepsis HIIN Tools: o o o Critical Care Gap Analysis Critical Care Checklist Critical Care Data Collection Tool Project Manager Support 18
19 Next Steps o Gather your Critical Care team o Watch for NYS Partnership for Patients announcements and upcoming events in your inbox o NYSPFP Project Managers will support you in: o Completing/repeating the ABCDEF Bundle action plan and the VAE action plan o Using the PAD data collection tool, if your facility does not have its own process to collect this information o Submitting delirium measure data monthly into the NYSPFP Data Portal
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