Branson Critical Care Unit to launch innovative delirium screening

Cox Medical Center Branson will soon implement an innovative delirium screening at its critical care unit.

Brady Chase, Clinical Nurse Educator for the Critical Care Unit (CCU), pushed for the screening after pouring over evidence-based research on the process.

Delirium, or altered mental state, affects 60 to 80% of patients on ventilators and is under recognized approximately 75% of the time, according to several studies. Chase believes this screening can bring those numbers down so that patients can get well faster.

“By implementing a screening and training on how to manage delirium, we can avoid or minimize delirium’s impact.” Chase said. “Some of the negative impact from delirium include a 10% increased risk of death and approximately 10 days added to the patient’s length of stay in the hospital.”

Another key factor is muscle wasting and weakness. “When a patient is just lying in a bed, their physical strength, muscle tone and body mass decreases which increases the chance of infection and long-term impairment,” Chase said. “So we want to get our patients sitting in a chair and even walking while on life support.”

The idea is to keep interventions meant to help the patient from actually hurting them.

“Their body experiences things it’s never experienced before,” said Michelle Honeywell, Nurse Manger of the CCU. “There are lots of wires, tubes and cords. This necessary machinery really can decrease the body’s ability to heal itself, so this screening helps identify factors early that could inhibit a patient’s ability to heal.”

Some interventions the CCU staff will use to prevent delirium include turning a patient’s bed toward the window to allow more natural light, helping exercise the patient’s body and delicately monitoring their medication to avoid over-sedation.

Chase says the CCU staff and the Branson campus as a whole are rallying behind the screening, preventing and managing delirium.

“We’re trying to live out the mission and vision of the organization to be the best for those who need us, and this is one more way to do that,” Chase said. “We’re bringing the best practice to our hospital – a practice that’s been proven elsewhere.”

Chief Nursing Officer and Vice-President of Clinical Services in Branson, Lynne Yaggy is proud of how the CCU team collaborated to bring this screening to Branson.

“Because we are a rural, community hospital, we are able to trial new things for the system, tweak what needs to be and be nimble enough to do that in a timely manner,” Yaggy said. “This environment allows for proof of concepts, if you will.”

Honeywell agrees. “I think people look at smaller hospitals and probably think they aren’t as innovative or up-to-date. I don’t believe that does us justice. We are very progressive in our care – just the right size to get new things rolling and prove it’s the way to go!”