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Journal Article


Gloger AN, Nakonezny PA, Phelan HA. J. Burn Care Res. 2019; ePub(ePub): ePub.


University of Texas Southwestern Medical Branch.


(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)






INTRODUCTION: One of the most widely used tools for delirium assessment in burn intensive care units is the Confusion Assessment Method for the Intensive Care Unit delirium assessment tool. However, some nurses struggle with inaccurate delirium documentation. This performance improvement project was undertaken to assess the impact that routine chart audits with tailored feedback would have on documentation accuracy.

METHODS: An a priori goal of at least 90% documentation accuracy was set by burn leadership at our academic, American Burn Association-verified burn center. For the pre-correctional feedback time period, nursing delirium documentation was reviewed for accuracy by the nurse educator. In the post-correctional feedback time period, an intervention was started in which the educator sent tailored feedback to nurses with inaccurate delirium documentation. A Poisson regression with robust standard errors was used to compare the proportions of correct delirium documentation for the pre-correctional feedback and post-correctional feedback time periods.

RESULTS: The overall rates of correct delirium documentation in the pre-correctional feedback time period were 49.15% (SD=31.86), 95% confidence interval (CI): 36.43-66.31. A significant increase was seen in the rates of correct delirium documentation for the post-correctional feedback time period [91.47% (SD=8.28), 95% CI: 87.45-95.67], p=0.0001. In the 4 months prior to starting corrective feedback 0 out of 5 (0%) audits reached the 90% goal of accurate delirium documentation. In the 8 months in which corrective feedback was being given, 9 out of 15 (60%) audits reached the compliance goal set by leadership.

CONCLUSION: Using corrective feedback improves the accuracy of nursing delirium documentation. EXTERNAL FUNDING: N/A.

© American Burn Association 2019. All rights reserved. For permissions, please e-mail:

Language: en


Accuracy; Burns; CAM-ICU; Delirium; Documentation; Nursing


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