Post educational audit on nurses’ awareness and ability to diagnose delirium in Cardiothoracic Intensive Care Unit – a service improvement project.
Background and Goal: 

An audit in an 18 bedded Cardiothoracic Intensive Care Unit (CTICU) in July 2014 showed that there was significant lack of knowledge amongst the nurses on delirium and it´s screening tool1 . Subsequently, educational intervention aimed at improvement in nurses’ awareness of delirium and knowledge of Confusion Assessment Method for ICU (CAM-ICU) took place. This re-audit aims to:
•	Assess nurses’ awareness of delirium and CAM-ICU subsequent to educational intervention.
•	Seek further information on factors preventing nurses from using CAM-ICU in daily routines.
•	Determine the feasibility of implementing CAM-ICU in CTICU. 
Materials and Methods:
Education consisted of multiple bedside 1:1 teaching via demonstration, observation and active listening events, monthly mandatory sessions, mock CAM-ICU tool exercises, and brainstorming interactions. A prospective, non-probability, convenience sample of nurses in CTICU was used. Similar questionnaire for both pre and post educational audit was applied. Data was collected electronically in April 2015, exported to excel and analysed. Statistical analysis was performed using independent sample T-test. 

Results and Discussion:
79 out of 100 nurses answered the questionnaire. Re-audit showed that the nurses who named CAM-ICU correctly, increased from 31% (n=26) to 80% (n=63) and confidence in using the tool increased from 14% (n=10) to 82% (n=54). The awareness of the nurses on delirium showed significant improvement in the post educational survey (p< 0.0118). Although 62% (n=49) of the nurses agreed that CAM-ICU could be performed in intubated patients, 71% considered it as the main barrier. Other main barriers were: 35% responders thought that they would not be able make a difference to delirium due to lack of equipment to orientate the patients and 33% stated lack of support from doctors. 

Conclusions:
Educational intervention was successful in increasing nurses awareness and ability to diagnose delirium on CTICU. Further educational emphasis will be placed on diagnosing delirium in intubated patients. Main barriers such as lack of support from doctors are being currently addressed in a separate audit. Targeting areas of difficulties may make implementation of CAM-ICU in daily practice feasible.

Post educational audit on nurses´ awareness and ability to diagnose delirium in a cardiothoracic intensive care unit - a service improvement project