{'fraction_non_alphanumeric': 0.02789400278940028, 'fraction_numerical': 0.008833100883310088, 'mean_word_length': 5.501510574018127, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
788: IMPLEMENTING CAM-ICU SCREENING IN THE NEURO-ICU: RESULTS OF AN ONGOING INITIATIVE

Learning Objectives: It is well acknowledged that screening for delirium is part of comprehensive care in the intensive care unit (ICU). However, limited information is available to guide clinicians with delirium screening for neurological ICU patients, as distinguishing delirium from neurological changes can be challenging. Prior to June 2015, the neurological sciences intensive care unit (NSICU) in a large, academic hospital was not screening patients for delirium. The CAM-ICU was selected for use as part of an ICU-wide research collaborative with special focus in assessing application to neurologically injured patients. Methods: A team was created to implement the use of the CAM-ICU in the critical care units with members from nursing, medicine, and the therapies. Education, consisting of 1:1 demonstration and voice-over power point was developed over the course of 6 weeks with the use of ICU Liberation materials. Educational sessions reviewed how to complete the assessment, long-term outcomes associated with a positive screen, and interventions to combat delirium. Documentation and workflows were evaluated and the CAM-ICU screening was reconfigured in the electronic medical record. An automatic report was created to generate data about the screening’s completion. CAMICU results are communicated during interdisciplinary rounds. Results: Rates of documentation of assessments were monitored over a 12 month period. Among NSICU patients (n=938), assessment documentation is trending upward (up to 56%), but has yet to reach the goal of 80% assessment in the NSICU. Clinicians report difficulty with differentiating neurological changes from delirium, which may have impacted screening rates.Conclusions: Implementation, reliability testing, and compliance monitoring of the CAM-ICU is needed in NSICU patients. The results of this ongoing initiative targeting use of the CAM-ICU with NSICU patients has demonstrated that education, audit and feedback has promoted improved screenings among neuroscience patients, but that limitations exist.