Law Tyler J, Leistikow Nicole A, Hoofring Laura, Krumm Sharon K, Neufeld Karin J, Needham Dale M
Department of Anesthesia, University of Toronto, Toronto, Canada.
Dynamics. 2012 Winter;23(4):18-24.
Delirium in critically ill patients is common and is associated with increased morbidity and mortality. Routine delirium screening is recommended by the Society of Critical Care Medicine. The Intensive Care Delirium Screening Checklist (ICDSC) is one validated and commonly-used tool, but little is known about nurses'perceptions of using the ICDSC, and of barriers to delirium assessment and treatment.
A survey was administered to 189 critical care-trained nurses working on four oncology inpatient units, where the ICDSC has been used for greater than five years.
Eighty-four nurses (44%) responded to the survey. Respondents indicated that they had knowledge of delirium, confidence in the ICDSC, and that the ICDSC was useful. Respondents perceived that physicians did not value the ICDSC results. Similar to prior nurse surveys for other delirium screening tools, physicians were the most frequently identified barrier to both delirium assessment and treatment, with other frequent barriers being lack of time, feedback on performance, and knowledge of delirium.
The ICDSC is viewed favourably by nurses with experience using the tool. Future delirium screening programs should encourage physician engagement early in the planning process to help address perceived barriers to delirium assessment and treatment.
重症患者谵妄很常见，且与发病率和死亡率增加相关。危重病医学会建议进行常规谵妄筛查。重症监护谵妄筛查检查表（ICDSC）是一种经过验证的常用工具，但对于护士使用ICDSC的看法以及谵妄评估和治疗的障碍知之甚少。
对在四个肿瘤住院病房工作的189名接受过重症监护培训的护士进行了一项调查，这些病房使用ICDSC已超过五年。
84名护士（44%）回复了调查。受访者表示他们了解谵妄，对ICDSC有信心，并且ICDSC很有用。受访者认为医生不重视ICDSC的结果。与之前针对其他谵妄筛查工具的护士调查类似，医生是谵妄评估和治疗最常被提及的障碍，其他常见障碍包括时间不足、对表现的反馈以及对谵妄的了解。
有使用该工具经验的护士对ICDSC评价良好。未来的谵妄筛查项目应在规划过程早期鼓励医生参与，以帮助解决所察觉到的谵妄评估和治疗障碍。
