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Implementing clinical practice guidelines for screening and detection of delirium in a 21-hospital system in northern California: real challenges in performance improvement.

Clin Nurse Spec

October 2016

Author Affiliations: Clinical Practice Consultant (Dr Adams) and Quality Strategy Leader, Quality Division Northern California Kaiser Permanente, Oakland (Dr Scruth); Intensive Care Unit (ICU) Clinical Nurse Specialist (CNS), Santa Rosa Kaiser Medical Center (Mss Andrade and Maynard); Neuro ICU CNS, Redwood City Kaiser Permanente Medical Center (Ms Snow); ICU CNS, Modesto Kaiser Medical Center (Ms Olson); ICU CNS, Vacaville Kaiser Medical Center (Mr Ingerson); Trauma ICU CNS, South Sacramento Kaiser Medical Center (Ms Duffy); and Medical Director Intensive Care Unit, San Jose Kaiser Medical Center-the Permanente Medical Group (Ms Cheng), California.

Purpose: The purpose of this article was to describe a quality improvement process on a diverse adult intensive care unit (ICU) population for a large healthcare organization for early detection of delirium.

Background: Delirium is often considered a common unpreventable problem in the ICU. A process for early detection of delirium allows the critical care team to evaluate the patient and intervene to improve or reverse the delirium.

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