1. Garolis, Salomeja RN, MS, CNS
  2. Kimball, Sharon RN, MS, CNL

Article Content


Acquiring new assessment skills requires multiple approaches to fully engage learners. Human simulation provides opportunity to practice new skills without involving patients. Our approach was to produce a delirium DVD that demonstrated the needed skills and modeled behavior for delirium management.



Delirium is considered a medical emergency. Early recognition and treatment are important to minimize adverse effects.



Unrecognized delirium was a contributing factor to harm from patient falls. An interdisciplinary team formed to revise delirium management orders. The team recommended the adoption of a standardized approach for medicine and nursing to screen patients for delirium. The Confusion Assessment Method (CAM) tool was selected based on evidence and quick administration.



By using the CAM, nursing can accurately screen for delirium and request early medical intervention to manage delirium. Volunteer nurses were instructed on how to use the CAM. Their feedback to the implementation team was to demonstrate the CAM rather than rely on didactic methods. The implementation team decided to access the simulation laboratory to produce a DVD that would demonstrate the 2 most common types of delirium, how to use the CAM, embed elements of delirium prevention and management into the scenario, and model how to contact physicians and communicate CAM findings to them. Traditionally, learners would come to the simulation site to experience the situation and then review the filmed scenario. Due to the volume of staff who needed the information and the desire to "pause" the scene and allow for dialogue, the team chose the DVD as one aspect of delirium education.



Education was done using the DVD as an introduction and then used written scenarios for the staff to practice applying the CAM. A review of the delirium protocol and order set was done. In 30 minutes, staff had relevant content and could apply the CAM.



Using the simulation lab to film the scene, plus add-in voiceovers to reinforce and clarify information materials, enhanced the learning experience. Through the use of visual, audio, motion, and printed material, multiple levels of learning were incorporated.


Implications for Practice:

Simulation can be taken to staff for successful learning.


Section Description

The 2010 National Association of Clinical Nurse Specialists (NACNS) Annual National Conference is planned for Portland, Oregon, on March 3 to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, "CNS as Internal Consultant: Influencing Local to Global Systems," demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.


A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.


The conference abstracts are published to share new knowledge with those unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics.


Watch for next year's call for abstracts and consider submitting for presentation at the next NACNS annual conference scheduled for March 9-12, 2011, in Baltimore, Maryland.