Research and Scholarship

An Advanced Practice Provider Initiative for Delirium Management in the ICU

Sarah Rebal, MS, RN, ACNP-BC, Caroline Shirzadi, MS, RN, ACNP-BC, Jennifer Agatep, Ms, RN, AGACNP, Konstantina Matsoukas, MLIS, Kay See Tan, PhD, Kenneth Seier, MS, Yesne Alici, MD, Beatriz Korc-Grodzicki, MD, PhD, and Louis Voigt, MD

From Memorial Sloan Kettering Cancer Center, New York, New York

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Sarah Rebal, MS, RN, ACNP-BC, 1275 York Avenue, New York, NY 10065. E-mail: rebals@msckcc.org

ABSTRACT

Delirium is the most common neuropsychiatric challenge in cancer patients, particularly in the critically ill population. Without a screening method and constant vigilance by providers, delirium is often misdiagnosed. The purpose of our pilot study was to determine if an educational program targeting critical care medicine advanced practice providers (APPs) and fellows in an oncologic intensive care unit would increase APP knowledge of delirium and their level of comfort with delirium screening and management. Thirty-one APPs and fellows participated in the program. Scores on knowledge-based delirium assessments increased significantly after the intervention and at the 3-month follow-up (p < .0001 and p < .0225, respectively). Providers’ comfort with delirium screening and management also improved after the intervention (p = .0020 and p < .0001, respectively) and decreased slightly at the 3-month follow-up (p = .1764 and p = .9840, respectively). A brief and focused APP-led educational initiative successfully improved knowledge of delirium and comfort with screening and management.

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