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  • NYSPFP HIIN: VAE/Delirium Prevention

    Non-pharmacological Interventions to prevent and manage delirium

    1

    May 30, 2017

  • NYS PARTNERSHIP FOR PATIENTS

    AgendaTopic SpeakerWelcome and Introductions NYSPFP Staff

    Surviving the ICU: A perspective from both sides of the bed

    Dr. Alison ClayProfessor Critical Care and SurgeryDuke University Medical CenterDurham, North Carolina

    An Ounce of Prevention: Non-pharmacologic Care for Delirium

    Dr. Tammy HshiehBrigham and Women's Hospital, Division of AgingBoston, Massachusetts

    Delirium Prevention: patient & hospital-wide benefits

    Dr. Jeffrey T. BergerChief of the Division of Palliative Medicine and BioethicsMaureen Gaffney, MHS, PA-C, RNSenior Vice President, Clinical OperationsNYU Winthrop Hospital

    Hospital Questions and Discussion Hospital Participants Tools and Resources/Next Steps NYSPFP Staff

  • NYSPFP Approach to VAE/Delirium Reduction

  • NYS PARTNERSHIP FOR PATIENTS

    VAE/Delirium Goal and Approach Goal: To reduce ventilator-associated events (VAE) by 20% and the incidence of iatrogenic delirium in critical care patients.

    Hospitals will focus on spreading interventions to reduce VAE and delirium throughout critical care units. NYSPFP will support hospitals in implementing evidence based strategies including:

    Implementation of the ABCDEF Bundle Implementing non-pharmacological interventions to prevent and

    manage delirium VAE:

    High Reliability in application of the VAP bundle Implementing emerging interventions aimed at reducing VAE

    4

  • NYS PARTNERSHIP FOR PATIENTS

    ABCDEF Bundle Components

  • NYS PARTNERSHIP FOR PATIENTS

    VAE/Delirium Measures for NYSPFP

    6

    NYSPFP MeasureCategory

    Measure(All ICU patients included in prevalence study)

    Delirium Process Pain assessment utilization rate (Manual Collection)Suggested Tool(s): CPOT or BPS

    Delirium Process Agitation assessment utilization rate (Manual Collection)Suggested Tool(s): RASS or SAS

    Delirium Process Delirium assessment utilization rate (Manual Collection)Suggested Tool(s): CAM-ICU or ICDSC

    Delirium Outcome Prevalence rate of ICU patients meeting the diagnostic criteria for delirium as measured by a delirium assessment (Manual Collection)

    VAE Process Ventilator Utilization Ratio

    VAE Outcome VAE Rate per 1,000 Ventilator Days (NHSN)

  • NYS PARTNERSHIP FOR PATIENTS

    PAD Assessment Tools

    7

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP VAE Rate

    8

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP IVAC Plus Total VAP Rate

    9

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP Ventilator Utilization Ratio

    10

  • Surviving the ICU: A perspective from both sides of the bed

    Dr. Alison Clay

    11

  • An Ounce of Prevention: Non-pharmacologic Care for Delirium

    Dr. Tammy Hshieh slides

  • Delirium Prevention: patient & hospital-wide benefits

    NYU Winthrop Hospital Team Dr. Jeffrey Berger

    Maureen Gaffney, MHS, PA-C, RN

  • Hospital Questions and Discussion NYSPFP StaffHospital Participants

    14

  • NYSPFP Delirium Data Entry, Tools and Resources

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP Website: Tools and Resources

    16

    www.nyspfp.org

    www.nyspfp.org/Members/Initiatives/InfectionPrevention/VAP/Tools.aspx

    Additional Resources:

    IPRO VAE Master Project Plan PAD Assessment Tools

    Critical Care Pain Observation Tool Behavioral Pain Scale Richmond Agitation-Sedation Scale Sedation Agitation Scale Complete CAM-ICU Training Manual Intensive Care Delirium Screening Checklist ABCDEF Bundle Action Planning Tool

    http://www.nyspfp.org/https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/VAP/Tools.aspx

  • NYS PARTNERSHIP FOR PATIENTS

    ABCDEF Bundle Action Planning Tool

  • May 30, 2017 1

  • NYS PARTNERSHIP FOR PATIENTS

    VAE Prevention Strategies and Hospital Action Planning tool

    https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/VAP/Tools.aspx

    19 May 27, 2017

    https://www.nyspfp.org/Members/Initiatives/InfectionPrevention/VAP/Tools.aspx

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP Delirium Data Entry

    20

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP PAD Process Measure Tracking Tool

    https://www.nyspfp.org/Materials/NYSPFP-Critical-Care-Data-PADTool.xlsx

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP Delirium Measure Data Entry

    22

  • NYS PARTNERSHIP FOR PATIENTS

    NYSPFP Delirium Measure Data Entry

    Monthly drop down

    Hit save

    23

  • NYS PARTNERSHIP FOR PATIENTS

    Critical Care Team Education & SupportTargeted education and tools for Critical Care Unit Staff: VAE/Delirium Prevention Daily Safety Checks Sepsis

    HIIN Tools: Critical Care Gap Analysis Critical Care Checklist Critical Care Data Collection Tool

    Project Manager Support

    24

  • NYS PARTNERSHIP FOR PATIENTS

    Next Steps Gather your Critical Care team NYS Partnership for Patients VAE/Delirium In-Person full

    day conference September 26, 2017 Syracuse, September 27, 2017 NYC SAVE THE DATE!

    NYSPFP Project Managers will support you in: Completing/repeating the ABCDEF Bundle action plan, Non-

    Pharmacological Interventions to prevent and manage Delirium gap analysis and action plan and the VAE action plan

    Using the PAD data collection tool, if your facility does not have its own process to collect this information

    Submitting delirium measure data monthly into the NYSPFP Data Portal

    NYSPFP HIIN: VAE/Delirium Prevention AgendaNYSPFP Approach to VAE/Delirium Reduction VAE/Delirium Goal and Approach ABCDEF Bundle ComponentsVAE/Delirium Measures for NYSPFP PAD Assessment ToolsNYSPFP VAE RateNYSPFP IVAC Plus Total VAP RateNYSPFP Ventilator Utilization RatioSurviving the ICU: A perspective from both sides of the bedAn Ounce of Prevention: Non-pharmacologic Care for Delirium Delirium Prevention: patient & hospital-wide benefitsHospital Questions and Discussion NYSPFP Delirium Data Entry, Tools and Resources NYSPFP Website: Tools and ResourcesABCDEF Bundle Action Planning ToolNon-pharmacological Interventions to Prevent and Manage Delirium Gap Analysis and Action PlanVAE Prevention Strategies and Hospital Action Planning tool NYSPFP Delirium Data EntryNYSPFP PAD Process Measure Tracking ToolNYSPFP Delirium Measure Data EntryNYSPFP Delirium Measure Data EntryCritical Care Team Education & SupportNext Steps

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