Using Telehealth to Improve the Accuracy of Delirium Screening by Bedside Critical Care Nurses

Liron Sinvani, MD; Craig Hertz, DO; Saurabh Chandra, MD; Anum Ilyas, BS; Suzanne Ardito, MA; Negin Hajizadeh, MD

Disclosures

Am J Crit Care. 2022;31(1):73-76. 

In This Article

Discussion

The use of tele-ICU to provide real-time observation and training on CAM-ICU administration to bedside critical care nurses is feasible and efficient. Although telehealth has been increasingly used in the ICU setting to provide clinical care, it has not previously been used to provide delirium training.

The tele-ICU platform has several advantages for bedside teaching. It offers the ability to leverage delirium expertise from 1 remote location to numerous ICUs, it offers bedside nurses a level of comfort (feeling less threatened), and it improves the engagement of bedside nurses with tele-ICU staff. Although no major barriers to implementing tele-delirium training existed, improved coordination for scheduling, initial introduction to the purpose of the training, and background information on delirium and the CAM-ICU would most likely improve efficiency and strengthen acceptance.

This study has several limitations. First, the small sample size limits generalizability. Second, it is not clear if the trained bedside nurses can serve as champions to train additional bedside nurses. Third, we did not evaluate retention of knowledge learned. Fourth, the trained research assistant did not have expertise in intensive care medicine. Fifth, unlike the 2-question satisfaction surveys, feedback elicited by the nurse manager was not anonymous.

Accurate delirium screening increased from 40% to 90%.

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