Background: Delirium is a disturbance of consciousness with an acute onset that varies from hours to days. Patients with delirium have a risk of increased length of stay, increased mortality, morbidity, and long-term cognitive effects. Therefore, the following PICOT question arises: In registered nurses in the acute care setting (P), how does education on use of the CAM (Confusion Assessment Method) tool (I) compared to those units not receiving education (C) affect recognition of delirium (O1) and use of the CAM tool (O2) over 6 weeks? (T)

Purpose: The evidence-based practice project described nurse education and pilot implementation using the Confusion Assessment Method (CAM) tool for delirium recognition.

Methodology: One-hour education sessions were offered for medical-surgical nurses on delirium and use of the CAM tool. The Nurse’s Knowledge of Delirium (NKD) questionnaire was given prior to the education session and repeated at six weeks. Participating nurses completed CAM assessments at shift change with scoring and observation by second observers.

Results: Forty-six nurses attended the education sessions. Twenty-three nurses completed all NKD questionnaire item pre- and post-responses. Scores overall increased from pre-education (mean 62.35, SD 12.28) to post-education (mean 73.609, SD 8.17). CAM screenings were documented over 50% more frequently during night shift. Nurses identified twenty-three positive CAM assessments during the pilot.

Recommendations: Delirium education is needed for early recognition and intervention. Medical-surgical nurses need targeted delirium educational programs and practice using the CAM tool.

Date of publication

Spring 4-28-2022

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Dr. Sandra Petersen, Dr. Lauri John, Dr. Cheryl Parker


Doctor of Nursing Practice

Included in

Nursing Commons