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Humber River Regional Hospital
Delirium CAM-ICU
Background
• Humber River Regional Hospital is one of Canada’s
largest regional acute care hospitals
• Serving a catchment area of more than 850,000 people
in the Northwest GTA
• The hospital currently operates on 3 sites with a total of
549 beds
• Our Critical Care Units are located at 2 of our sites with a
total of 28 beds
• We look to our patients to share their hospital
experiences with us in guiding us towards developing
plans for success and improvement across the
organization
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Aim
• Identify Critical Care patients at risk of delirium with
the use of CAM-ICU at both of our sites
Goals/Objectives:
• To implement delirium protocol in the ICU by
December 2012
• To assess the impact of the protocol on current self
extubation rates
• Early identification of patients with delirium
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Team Members
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Yemi Adebayo- Manager Finch ICU
Shirley Goguen- CPL Finch ICU
Sarah Morris- CPL Church ICU
Claudia Mitchell- Manager Church ICU
Dr Terry Cooligan- Intensivist
Mojgan Khoravis-Babadi- Pharmacist
Paula Abramczyk-Cazes- Social Worker
Jinhee Oh- Pharmacist
Cecile Marville- Williams- Sponsor
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Results
• Compliance with use of the Richmond Agitation
Sedation Score in documentation
• Identifying and reporting symptoms of delirium in
daily rounds
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Changes Tested
• Started to look at incidence of delirium among
patients during daily rounds
• Compliance to Richmond Agitation Sedation Scale
(RASS)
• Roll out of our ICU daily rounds sheet which includes
daily assessment of delirium
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Lessons Learned
• Need for staff to understand the causes of delirium,
including medications (eg Benzodiazepines) and
other predisposing factors
• Need for education for appropriate use of CAM-ICU
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Next Steps
• Continue with Education Roll out of CAM-ICU
• Auditing compliance with using CAM-ICU
• Ongoing education on importance of Delirium
Assessment
• Family education using a Delirium information
package
• Reiterating the importance of communication with
the patient/family and health care team
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