使用谵妄筛查工具和多方面的教育对护士对谵妄的认识和正确评估能力的影响。
Impact of a delirium screening tool and multifaceted education on nurses' knowledge of delirium and ability to evaluate it correctly.
机构信息
Division of Trauma and Surgical Critical Care, Carolinas Medical Center, Charlotte, North Carolina 28232, USA.
出版信息
Am J Crit Care. 2012 Jan;21(1):e1-11. doi: 10.4037/ajcc2012605.
BACKGROUND
The impact of using a validated delirium screening tool and different levels of education on surgical-trauma intensive care unit (STICU) nurses' knowledge about delirium is unclear.
OBJECTIVES
To measure the impact of using the Intensive Care Delirium Screening Checklist (ICDSC), with or without a multi-faceted education program, on STICU nurses' knowledge and perceptions of delirium and their ability to evaluate it correctly.
METHODS
The knowledge and perceptions of subject nurses about delirium, and agreement between the independent assessments of delirium by the subject nurse and by a validated judge (who always used the ICDSC), were compared across 3 phases. Phase 1: No delirium screening tool and no education. Phase 2: ICDSC and minimal education (ie, ICDSC validation study only). Phase 3: ICDSC and multifaceted education (ie, pharmacist-led didactic lecture, Web-based module, and nurse-led bedside training).
RESULTS
Nurses' knowledge (mean [SD] score out of 10 points) was similar (P = .08) in phase 1 (6.1 [1.4]) and phase 2 (6.5 [1.4]) but was greater (P = .001) in phase 3 (8.2 [1.4]). Agreement between nurses and the validated judge in the assessment of delirium increased from phase 1 (κ = 0.40) to phase 2 (κ = 0.62) to phase 3 (κ = 0.74). Nurses perceived use of the ICDSC as improving their ability to recognize delirium.
CONCLUSIONS
Use of a multifaceted education program improves both nurses' knowledge about delirium and their perceptions about its recognition. Implementation of the ICDSC improves the ability of STICU nurses to evaluate delirium correctly.
背景
使用经过验证的谵妄筛查工具和不同教育水平对外科-创伤重症监护病房（STICU）护士对谵妄的认知的影响尚不清楚。
目的
测量使用重症监护谵妄筛查检查表（ICDSC），结合或不结合多方面的教育计划，对 STICU 护士对谵妄的知识和认知，以及正确评估谵妄的能力的影响。
方法
在 3 个阶段比较了主题护士对谵妄的知识和认知，以及主题护士对谵妄的独立评估与经过验证的判断者（始终使用 ICDSC）之间的一致性。第 1 阶段：无谵妄筛查工具且无教育。第 2 阶段：ICDSC 和最低限度的教育（即，ICDSC 验证研究）。第 3 阶段：ICDSC 和多方面的教育（即，药剂师主导的讲座、基于网络的模块和护士主导的床边培训）。
结果
护士的知识（10 分制得分）在第 1 阶段（6.1 [1.4]）和第 2 阶段（6.5 [1.4]）相似（P =.08），但在第 3 阶段（8.2 [1.4]）更高（P =.001）。护士和经过验证的判断者在评估谵妄方面的一致性从第 1 阶段（κ = 0.40）提高到第 2 阶段（κ = 0.62），再到第 3 阶段（κ = 0.74）。护士认为使用 ICDSC 提高了他们识别谵妄的能力。
结论
使用多方面的教育计划可提高护士对谵妄的认知和对其识别的认识。实施 ICDSC 可提高 STICU 护士正确评估谵妄的能力。
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