26 Empowering Nursing Staff to Identify Delirium and Provide Intervention for Older Patients Post Transcatheter Aortic Valve Implantation Procedure in A Cardiology Ward: A Quality Improvement Project

Background Delirium is a common condition, particularly in the hospital setting, and has associated poor outcomes. Transcathether Aortic Valve Implantation provides a less invasive intervention for the treatment of Aortic Stenosis and this patient group often presents with increased risk factors for delirium. Nurses are in a key position to identify and manage delirium with literature suggesting educational interventions can support this. Aim The aim of the quality improvement project is to empower nursing staff to identify delirium and provide intervention for older patients post Transcatheter Aortic Valve Implantation procedure in a cardiology ward. Methods A driver diagram supported local problem analysis and stakeholder analysis identified those required to support change. The Behaviour Change Wheel and COM-B system identified behaviours required for change and guided intervention design. Plan, Do, Study, Act cycles directed project planning and the implementation of interventions. Results Nurse knowledge of delirium scores increased for ten out of twenty-three nurses or 43.7% post delirium training session. Nurse self-perceived confidence increased in three aspect of delirium care: recognising signs and symptoms, undertaking screening and delivering interventions for the management of it. All nurses were either likely or extremely likely to recommend both delirium training sessions provided to their colleagues. When comparing the data prior to and during the QIP intervention, an increased in identification and management of delirium was demonstrated. However demonstrating if there is a direct correlation between nursing staff attending delirium training sessions and patients having increased identification of delirium and management interventions has been more difficult to ascertain. Conclusions The Quality Improvement Project was well received and useful in raising awareness of delirium and enhancing nurse knowledge and confidence in delirium care. Next steps involve additional delirium training and data collection to explore the impact of the interventions further. Feedback has been positive and discussions about potential spread to other contexts and care pathways have taken place.