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0057_SHVGR_Delirium and Delirium Related Distress- Novel Strategies for Prevention and Early Intervention in the ICU and Beyond_Live
Course Description
Delirium is one of the most common acute care complication and is independently associated with many short- and long-term sequalae including increased risk of mortality, increased prevalence of dementia, and a high-prevalence of acute distress as well as Post-Traumatic Stress Disorder (PTSD) for patients and families. Despite these concerns, the primary practice gap is one of ineffective processes to achieve meaningfully improved outcomes. On World Delirium Awareness Day, this presentation seeks to build awareness about delirium, delirium-related distress, and novel strategies for prevention or early intervention with recommendations shared via a panel discussion between an intensivist, a critical care educator, and a nurse who had the lived experience of being a family member witnessing their loved one's distress in the Intensive Care Unit.
Target Audience
Nurse Practitioner (NP)
Nurse, Registered (RN)
Pharmacists (PharmD)
Physicians (MD or DO)
Physician Assistant (PA)
Psychologists
Social Workers
Other Healthcare Professionals
Students of Health Professions
Learning Objectives
After attending this activity, learners should be able to:
1. Analyze current care practices that contribute to poor outcomes for patients with delirium and their family members.
2. Summarize the critical need to to implement sedation- and restraint-minimizing strategies, such as the Awake & Walking model of ICU care, to reduce the occurrence of delirium and delirium-associated distress.
3. Engage ICU patients and their family members in discussion reflective of shared decision-making as a delirium prevention/early intervention strategy.
4. Collaborate with key stakeholders on how to best facilitate improved delirium care standards across the continuum of care.
References for Providing Culturally Appropriate Delirium Care which is Free of Implicit Biases
Learners are strongly encouraged to engage in self-directed learning relate to the impact of SDOH and implicit biases via the references below:
- Arias, F., Alegria, M., Kind, A.J., Jones, R.N., Travison, T.G., Marcantonio, E.R., Schmitt, E.M., Fong, T.G. & Inouye, S.K. (2022). A framework of social determinants of health for delirium tailored for older adults. Journal of the American Geriatrics Society; 70: 235-424. https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17465
- Abdelrahman, A., Borden, M., & Ghamloush, M.A. (2018). Agitated delirium in an intravenous drug user: Don’t jump to conclusions. Am J Respir Crit Care Med; 197. https://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2018.197.1_MeetingAbstracts.A6929
- Benhamed, A., Boucher, V. & Emond, M. (2022). Pain management in emergency department older adults with pelvic fracture: Still insufficient. Canadian Journal of Emergency Medicine; 24: 245-246. https://link.springer.com/article/10.1007/s43678-022-00299-9 Key Takeaways Include:
- “Untreated pain has been associated with the incidence of delirium and behavioral issues such as agitation, aggression, wandering, and refusal of care. Daoust et al. showed that untreated pain in more strongly associated with delirium than opioids.”
- “A recent meta-analysis showed that cognitively impaired hip fracture patients receive significantly less opioids. Several other factors, such as ethnicity, gender, social background, and advanced age may indeed influence pain expression. Healthcare professionals’ unconscious bias may also contribute to oligoanalgesia in the ED.”
- “Systematic changes, such as unconscious bias training, implementing validated senior-friendly pain assessment tools and protocols, dedicated multimodal analgesic strategies, including nonpharmacological approaches, may also help improve (care) in older adults.”
Disclosure of Financial or In-Kind Commercial Support & Conflict of Interest
Sophia Humphreys, a planning team member for this activity, receives honoraria form Pharmacosmos for her role consulting on the IV Iron Consensus paper which was deemed not relevant to this activity’s topic. Further, she has recently ended financial relationships with the following ineligible companies: Coherus Bioscience (ended 11/2021), Fresenius Kabi (ended 10/2022), and Heron (ended 10/2022).
No one involved in the planning or presentation of this educational activity have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. No financial or in-kind commercial support was received to produce or promote this educational activity.
Kerri Maya, RN, PhD(c), MSL, RN, NPD-BC
Brian Bellucci, MD
Kerri Maya, RN, PhD(c), MSL, RN, NPD-BC
Accreditation
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), and the Association of Social Work Boards (ASWB) to provide continuing education for the healthcare team.
Credit Designation Statement
Sutter Health designates this LIVE activity for a maximum of 1.25 AMA PRA Category 1 Credits™ for physicians, 1.25 continuing professional development contact hours for nurses, 1.25 knowledge-based contact hours for pharmacists, and 1.25 approved continuing education hours for social workers. Learners should claim only the credit commensurate with the extent of their participation in the activity.
Note to Other Disciplines: AMA PRA Category 1 Credits™ Continuing Medical Education is acceptable for meeting the continuing education requirements for Pharmacists, Physician Assistants, Psychologists, Registered Nurses, and Respiratory Care Practitioners. For other disciplines, please check with the regulatory board for your discipline to confirm what type of credits meet the continuing education requirements. Continuing education hours for nurses accredited by ANCC, via Joint Accreditation.
Attendance & Credit Claiming
Text the 6-letter attendance verification code to (916) 866-7913 to claim credit.
Available Credit
- 1.25 ACPE
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Sutter Health designates this Live activity for a maximum of 1.25 of ACPE credit(s). Credits for pharmacists and technicians will be transmitted to CPE Monitor and will be available within 60 days post-activity pending submission of individual NABP e-PID and DOB (mm/dd only). Learners should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 AMA PRA Category 1 Credit™
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Sutter Health designates this Live activity for a maximum of 1.25 AMA PRA Category 1 Credit™ for physicians. Learners should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 AMA PRA Category 1 Credit™ Hour(s)
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Sutter Health certifies this Live activity was designated for a maximum of 1.25 AMA PRA Category 1 Credit™ Hour(s). Non-physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 ANCC
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This course/program has been awarded 1.25 ANCC contact hour(s). Sutter Health is accredited provider of nursing continuing professional development. Learners should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 ASWB-ACE
As a Jointly Accredited Organization, Sutter Health is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 continuing education credits.
- 1.25 CA BRN
This activity is approved for 1.25 contact hour(s) by Sutter Health, which is an approved provider by the California Board of Registered Nursing. (Provider Number 17182). Learners should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 IPCE
This activity was planned by and for the healthcare team, and learners will receive 1.25 Interprofessional Continuing Education (IPCE) credit for learning and change.
