LAUSR

www.ccmjournal.org Critical Care Medicine • Volume 46 • Number 1 (Supplement) Learning Objectives: ICU delirium is an independent predictor of increased mortality, length of stay, and long term cognitive impairment. Our institution routinely screens all ICU patients using the Intensive Care Delirium Screening Checklist (ICDSC) as recommended by the Pain, Agitation, and Delirium guidelines. A score of ≥ 4 shows a strong correlation with ICU delirium. This positive score triggers an evaluation by the ICU pharmacist to recommend discontinuing deliriogenic medications or to initiate pharmacologic treatment of delirium. This purpose of this quality improvement project is to evaluate the impact of pharmacist assessment on outcomes in patients with ICU delirium. Methods: This is a single center, retrospective review of adult ICU patients with ≥ 1 positive ICDSC score. The pre intervention group included 100 patients from June 2015-May 2016. The postintervention group consisted of 100 patients from June 2016-May 2017 after the pharmacist delirium assessment service was in place. Primary outcome was the percent of positive ICDSC scores. Secondary outcomes included use of haldol, benzodiazepines, ICU LOS and days on mechanical ventilation. Results: The post intervention group had on average, 19% positive ICDSC scores as compared to the pre intervention group with 23%, p = 0.08. Patients with a completed pharmacist delirium assessment were administered less haldol than patients with no pharmacist assessment; 5.3 mg vs 18.9 mg respectively, p < 0.05. Patients with a pharmacist assessment spent fewer days in the ICU (8.9 days) compared to patients not assessed by a pharmacist (13.8 days) p < 0.05. Patients assessed by a pharmacist also experienced less ventilator days versus those without an assessment (5.31 and 8.95 days respectively) but this finding did not reach statistical significance (p = 0.07). There was no difference in the use of benzodiazepines between the two groups. Conclusions: In this evaluation, a medication assessment by pharmacists in patients screening positive for ICU delirium resulted in less haldol use and fewer days in the ICU. Although there was not a significant decrease in the percentage of positive ICDSC scores, this type of pharmacist service may contribute to the prevention and treatment of ICU delirium.