Niagara Health


Type of Practice


Pain, agitation and delirium (PAD) are often cluster symptoms that make the patient and family experience difficult. As the population in Niagara region has shifted with the demographic having more seniors, in 2016 Niagara Health embarked upon the impact of a multidisciplinary interventions on PAD in a community ICU the St. Catharines Site. It was designed to explore barriers to evidence-based PAD management practices and evaluate the impact of a Multifaceted Multidisciplinary Intervention within an ICU. It comprises two phases: PAD program phase I and PAD program Phase II. The PAD program phase I consisted of 3 components: a nurse survey, nurse focus groups, and nurse educations sessions. As a result of this PAD phase I, the implementation of a multifaceted nurse engagement intervention was associated with improved rates of daily PAD assessment in a community ICU (we found improvements in screening rates of 8% for pain, 14% for agitation, and 15% for delirium). The PAD program phase II consists of the implementation of additional interventions targeting physicians (round scripts), nurses (cue cards, e-modules and a poster), and families (interview, pamphlet and an educational video) to enhance the practice and not be discipline specific. 

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