Problem: Pediatric Delirium (PD) affects up to 34% of all hospitalized children and leads to extended hospitalizations, prolonged mechanical ventilation, and increased morbidity and mortality. A retrospective chart audit in Fall 2023 revealed that no patients received documented non-pharmacological interventions to prevent PD despite 22% (n=9) scoring positive for delirium on the validated Cornell Assessment of Pediatric Delirium (CAPD) in the Pediatric/Pediatric Cardiac Intensive Care Unit (PICU/PCICU). Purpose: The purpose of this quality improvement project is to implement evidence-based, shift-specific, non-pharmacologic interventions in a 19-bed PICU/PCICU and measure adherence. Methods: Ear plugs, earmuffs, and eye masks were approved and ordered by the unit manager. Smart phrase options were generated to standardize documentation of interventions in the electronic health record (EHR). Prior to project implementation, 50 nurses (RN), 4 patient care technicians, 1 nurse manager, and 1 nurse educator were educated. Weekly chart audits of the interventions and documentation were used to assess adherence to the practice change. Run charts were used to demonstrate change in the process measures over time. Results: Day shift implementation and documentation of non-pharmacologic intervention adherence was 74% (n=110). Night shift non-pharmacologic interventions and documentation adherence was 37% (n=55). CAPD scores were documented in the EHR for 95% (n=147) of patients. A positive CAPD score was documented in 5% (n=8) of patients. Twenty-five percent (n=2) received necessary referral to charge RN and first-call provider. Conclusions: Standardized documentation with smart phrases improved documentation adherence. More champions and reinforcement are needed on night shift to improve adherence to practice change.