Development and Validation of an ICU Delirium Playbook for Provider Education
OBJECTIVES:. Although delirium detection and prevention practices are recommended in critical care guidelines, there remains a persistent lack of effective delirium education for ICU providers. To address this knowledge-practice gap, we developed an “ICU Delirium Playbook” to educate providers on de...
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-07-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000939 |
| _version_ | 1797770610084937728 |
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| author | Hirsh Makhija, MS Janelle M. Fine, BS Daniel Pollack, MSN, APRN, ACCNS-AG, CCRN Francesca Novelli, MSN, RN, CCRN Judy E. Davidson, DNP, RN, MCCM, FAAN Shannon A. Cotton, BSN, RN, CCRN Bianca Diaz De Leon, BS, BA Paola Alicea Reyes, BS Jessica L. Montoya, PhD Carmen Mabel Arroyo-Novoa, PhD, RN, MSN, MSc, FCCM Milagros I. Figueroa-Ramos, PhD, RN, MSN, FCCM Yeonsu Song, PhD, RN, FNP Ana Lucia Fuentes, MD Jamie Nicole LaBuzetta, MD, MSc, MPhil Alison A. Moore, MD, MPH E. Wesley Ely, MD, MPH Atul Malhotra, MD Dale M. Needham, MD, PhD Jennifer L. Martin, PhD Biren B. Kamdar, MD, MBA, MHS |
| author_facet | Hirsh Makhija, MS Janelle M. Fine, BS Daniel Pollack, MSN, APRN, ACCNS-AG, CCRN Francesca Novelli, MSN, RN, CCRN Judy E. Davidson, DNP, RN, MCCM, FAAN Shannon A. Cotton, BSN, RN, CCRN Bianca Diaz De Leon, BS, BA Paola Alicea Reyes, BS Jessica L. Montoya, PhD Carmen Mabel Arroyo-Novoa, PhD, RN, MSN, MSc, FCCM Milagros I. Figueroa-Ramos, PhD, RN, MSN, FCCM Yeonsu Song, PhD, RN, FNP Ana Lucia Fuentes, MD Jamie Nicole LaBuzetta, MD, MSc, MPhil Alison A. Moore, MD, MPH E. Wesley Ely, MD, MPH Atul Malhotra, MD Dale M. Needham, MD, PhD Jennifer L. Martin, PhD Biren B. Kamdar, MD, MBA, MHS |
| author_sort | Hirsh Makhija, MS |
| collection | DOAJ |
| description | OBJECTIVES:. Although delirium detection and prevention practices are recommended in critical care guidelines, there remains a persistent lack of effective delirium education for ICU providers. To address this knowledge-practice gap, we developed an “ICU Delirium Playbook” to educate providers on delirium detection (using the Confusion Assessment Method for the ICU) and prevention.
DESIGN:. Building on our previous ICU Delirium Video Series, our interdisciplinary team developed a corresponding quiz to form a digital “ICU Delirium Playbook.” Playbook content validity was evaluated by delirium experts, and face validity by an ICU nurse focus group. Additionally, focus group participants completed the quiz before and after video viewing. Remaining focus group concerns were evaluated in semi-structured follow-up interviews.
SETTING:. Online validation survey, virtual focus group, and virtual interviews.
SUBJECTS:. The validation group included six delirium experts in the fields of critical care, geriatrics, nursing, and ICU education. The face validation group included nine ICU nurses, three of whom participated in the semi-structured feedback interviews.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. The 44-question quiz had excellent content validity (average scale-level content validity index [S-CVI] of individual items = 0.99, universal agreement S-CVI = 0.93, agreement κ ≥ 0.75, and clarity p ≥ 0.8). The focus group participants completed the Playbook in an average (sd) time of 53 (14) minutes, demonstrating significant improvements in pre-post quiz scores (74% vs 86%; p = 0.0009). Verbal feedback highlighted the conciseness, utility, and relevance of the Playbook, with all participants agreeing to deploy the digital education module in their ICUs.
CONCLUSIONS:. The ICU Delirium Playbook is a novel, first-of-its-kind asynchronous digital education tool aimed to standardize delirium detection and prevention practices. After a rigorous content and face validation process, the Playbook is now available for widespread use. |
| first_indexed | 2024-03-12T21:25:40Z |
| format | Article |
| id | doaj.art-749ed5e441f449ddbe6c8d844b9b2eba |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-03-12T21:25:40Z |
| publishDate | 2023-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-749ed5e441f449ddbe6c8d844b9b2eba2023-07-28T09:28:11ZengWolters KluwerCritical Care Explorations2639-80282023-07-0157e093910.1097/CCE.0000000000000939202307000-00012Development and Validation of an ICU Delirium Playbook for Provider EducationHirsh Makhija, MS0Janelle M. Fine, BS1Daniel Pollack, MSN, APRN, ACCNS-AG, CCRN2Francesca Novelli, MSN, RN, CCRN3Judy E. Davidson, DNP, RN, MCCM, FAAN4Shannon A. Cotton, BSN, RN, CCRN5Bianca Diaz De Leon, BS, BA6Paola Alicea Reyes, BS7Jessica L. Montoya, PhD8Carmen Mabel Arroyo-Novoa, PhD, RN, MSN, MSc, FCCM9Milagros I. Figueroa-Ramos, PhD, RN, MSN, FCCM10Yeonsu Song, PhD, RN, FNP11Ana Lucia Fuentes, MD12Jamie Nicole LaBuzetta, MD, MSc, MPhil13Alison A. Moore, MD, MPH14E. Wesley Ely, MD, MPH15Atul Malhotra, MD16Dale M. Needham, MD, PhD17Jennifer L. Martin, PhD18Biren B. Kamdar, MD, MBA, MHS191 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.1 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.2 Nursing Education & Development Research Department, UCSD Health, San Diego, CA.2 Nursing Education & Development Research Department, UCSD Health, San Diego, CA.2 Nursing Education & Development Research Department, UCSD Health, San Diego, CA.2 Nursing Education & Development Research Department, UCSD Health, San Diego, CA.1 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.6 School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.5 Department of Psychiatry, UCSD Health, San Diego, CA.7 School of Nursing, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.7 School of Nursing, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.8 School of Nursing, University of California, Los Angeles (UCLA), Los Angeles, CA.1 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.11 Division of Neurocritical Care, UCSD Health, San Diego, CA.12 Division of Geriatrics, Gerontology and Palliative Care, UCSD Health, San Diego, CA.13 Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN.1 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.16 Division of Pulmonary & Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.9 Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA.1 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego (UCSD) Health, San Diego, CA.OBJECTIVES:. Although delirium detection and prevention practices are recommended in critical care guidelines, there remains a persistent lack of effective delirium education for ICU providers. To address this knowledge-practice gap, we developed an “ICU Delirium Playbook” to educate providers on delirium detection (using the Confusion Assessment Method for the ICU) and prevention. DESIGN:. Building on our previous ICU Delirium Video Series, our interdisciplinary team developed a corresponding quiz to form a digital “ICU Delirium Playbook.” Playbook content validity was evaluated by delirium experts, and face validity by an ICU nurse focus group. Additionally, focus group participants completed the quiz before and after video viewing. Remaining focus group concerns were evaluated in semi-structured follow-up interviews. SETTING:. Online validation survey, virtual focus group, and virtual interviews. SUBJECTS:. The validation group included six delirium experts in the fields of critical care, geriatrics, nursing, and ICU education. The face validation group included nine ICU nurses, three of whom participated in the semi-structured feedback interviews. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. The 44-question quiz had excellent content validity (average scale-level content validity index [S-CVI] of individual items = 0.99, universal agreement S-CVI = 0.93, agreement κ ≥ 0.75, and clarity p ≥ 0.8). The focus group participants completed the Playbook in an average (sd) time of 53 (14) minutes, demonstrating significant improvements in pre-post quiz scores (74% vs 86%; p = 0.0009). Verbal feedback highlighted the conciseness, utility, and relevance of the Playbook, with all participants agreeing to deploy the digital education module in their ICUs. CONCLUSIONS:. The ICU Delirium Playbook is a novel, first-of-its-kind asynchronous digital education tool aimed to standardize delirium detection and prevention practices. After a rigorous content and face validation process, the Playbook is now available for widespread use.http://journals.lww.com/10.1097/CCE.0000000000000939 |
| spellingShingle | Hirsh Makhija, MS Janelle M. Fine, BS Daniel Pollack, MSN, APRN, ACCNS-AG, CCRN Francesca Novelli, MSN, RN, CCRN Judy E. Davidson, DNP, RN, MCCM, FAAN Shannon A. Cotton, BSN, RN, CCRN Bianca Diaz De Leon, BS, BA Paola Alicea Reyes, BS Jessica L. Montoya, PhD Carmen Mabel Arroyo-Novoa, PhD, RN, MSN, MSc, FCCM Milagros I. Figueroa-Ramos, PhD, RN, MSN, FCCM Yeonsu Song, PhD, RN, FNP Ana Lucia Fuentes, MD Jamie Nicole LaBuzetta, MD, MSc, MPhil Alison A. Moore, MD, MPH E. Wesley Ely, MD, MPH Atul Malhotra, MD Dale M. Needham, MD, PhD Jennifer L. Martin, PhD Biren B. Kamdar, MD, MBA, MHS Development and Validation of an ICU Delirium Playbook for Provider Education Critical Care Explorations |
| title | Development and Validation of an ICU Delirium Playbook for Provider Education |
| title_full | Development and Validation of an ICU Delirium Playbook for Provider Education |
| title_fullStr | Development and Validation of an ICU Delirium Playbook for Provider Education |
| title_full_unstemmed | Development and Validation of an ICU Delirium Playbook for Provider Education |
| title_short | Development and Validation of an ICU Delirium Playbook for Provider Education |
| title_sort | development and validation of an icu delirium playbook for provider education |
| url | http://journals.lww.com/10.1097/CCE.0000000000000939 |
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