Document Type

DNP - Open Access

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Brandi Pravecek


Background/Purpose: Delirium is a complex clinical syndrome comprising a constellation of symptoms, including acute onset, inattention, altered level of consciousness, and disorganized thinking or cognitive dysfunction. Delirium is a common complication often unrecognized, expensive, and preventable. This project's focus was further exploring non-pharmacological delirium prevention strategies (NDPS).
Methods: A NDPS program using a therapeutic activity book (TAB) was implemented in a Midwestern acute care hospital measuring the impact on the number of positive delirium screens, the number of delirium diagnoses, and hospital length of stay (LOS).
Results: A causative relationship or association between the TAB and outcomes could not be determined. Statistical analysis was completed using a pre-and post-implementation design using two proportion z-tests, α = 0.05. There was a statistically significant increase in the proportion of positive screens during the implementation period. There was not a statistically significant difference in the proportion of delirium diagnoses. The average LOS increased during the implementation period when compared to the preceding 90-days.
Discussion: Causation of the statistical significance for the high proportion of positive delirium screens remains unknown. Contributing factors to this significance may include an increased awareness or improved assessment technique for delirium screenings. Implications for Practice: Implementing NDPS may improve patient outcomes by reducing the risk of developing delirium and delirium-associated complications. Further investigation with detailed analysis is needed.


South Dakota State University