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Background/Purpose: Delirium, an acute disorder with decline of attention and cognition, is a clinical complication for many hospitalized older adults leading to increases in mortality, length of stay, falls, rate of discharge to long-term care, and cognitive and functional decline. Thirty to 40 percent of cases are preventable. Early delirium recognition, prevention, and management are needed to improve safety and quality of care for this vulnerable population. Nurses are key to detecting and reporting delirium symptoms. Evidence indicates that education programs regarding delirium recognition and management are needed and are a priority in delirium clinical practice guidelines. A multifaceted education intervention is described most frequently in the evidence. The purpose of this translation project is to implement an evidence-based intervention of a multifaceted delirium education program for nurses to increase delirium recognition, screening, and implementation of non-pharmacological interventions for hospitalized patients 65 years and older on a 55-bed adult medical-surgical unit. Methods: The Johns Hopkins Nursing Evidence-Based Practice Model was used to guide the evidence search, appraisal, synthesis, and translation. Best practices to improve nurses' delirium knowledge and recognition were determined. Translation of the evidence began September 2015 with nursing staff participating in a multifaceted delirium intervention that included a pre-intervention knowledge questionnaire, a computer based training module, didactic in-services, bedside coaching, and a post-intervention knowledge questionnaire. Results: Outcome metrics including delirium screening, non-pharmacological intervention plan of care, and delirium incidence are being collected through December 2015 and will be compared to pre-implementation baseline metrics. Conclusions/Implications: Translating an evidence-based multifaceted education intervention in a large medical unit with multiple stakeholders is challenging. Increasing delirium recognition by nurses has been shown to decrease adverse outcomes for the older hospital patient. Creating multifaceted education opportunities for the nursing staff assists in gaining stakeholder buy-in and sustaining practice change. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the impact of process standard work, a quality improvement tool, on staff adherence to nurse-driven unfractionated heparin (UFH) protocols in adult patients at a community teaching hospital. Methods: This was a retrospective quality improvement project, and statistical analysis was performed by a senior research specialist at the facility. Results: In total, 109 venous thromboembolism or cardiac UFH anticoagulant protocols were included in the final analysis, accounting for 445 activated partial thromboplastin time results. Conclusion: There was no change in adherence to a nurse-driven UFH protocol among adult patients after the implementation of process standard work. [ABSTRACT FROM AUTHOR]