Delirium Knowledge and Screening Practices in Postoperative Cardiac Surgery: A Quality Improvement Project

Background Postoperative delirium (POD) is common yet often underrecognized in older adults undergoing cardiac surgery. Staff education is essential for evidence-based delirium care in the postoperative setting. Objective To implement and evaluate a delirium education program for nursing staff in a postoperative cardiac surgery setting. Methods This uncontrolled before-and-after quality improvement project implemented structured delirium education for nursing staff at an 80-bed cardiac specialty hospital during competency updates, team meetings, and a lunch-and-learn session. Educational content included didactic learning, case studies, one-on-one demonstrations of validated delirium assessments, and integration of delirium as a quality metric into daily leadership rounds. Outcomes included pre- and post-intervention Nurses’ Delirium Knowledge Assessment (NDKA), delirium screening documentation frequency, and timing of geriatric consultation. Results Participants’ knowledge of delirium improved following education. The mean NDKA score increased from 20.53 (SD = 2.53) to 22.65 (SD = 1.93), t(16) = -3.65, p = .002, with a large effect size (d = 0.884). Following education, the mean delirium assessment documentation completion rate for day shift increased from 46% to 56%, t(89) = 2.05, p = .044, d = 0.43. The mean postoperative day of geriatric consultation decreased from 4.20 to 2.33 days; however, this difference was not statistically significant (d = 0.81; n = 16). Conclusion Education improved nurses’ knowledge and delirium screening documentation. A nonsignificant trend toward earlier geriatric consultation was observed, though limited by sample size. These findings support the role of structured delirium education in promoting evidence-based postoperative delirium care.