van de Steeg Lotte, IJkema Roelie, Wagner Cordula, Langelaan Maaike
NIVEL Netherlands institute for health services research, Utrecht, the Netherlands.
Present affiliation: Erasmus Medical Centre, Rotterdam, the Netherlands.
BMC Med Educ. 2015 Feb 5;15:12. doi: 10.1186/s12909-015-0289-2.
Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which might be due to a lack of knowledge of delirium diagnosis and treatment. The objective of the study was to test the effectiveness of an e-learning course on nurses' delirium knowledge, describe nursing staff's baseline knowledge about delirium, and describe demographic factors associated with baseline delirium knowledge and the effectiveness of the e-learning course.
A before-and-after study design, using an e-learning course on delirium. The course was introduced to all nursing staff of internal medicine and surgical wards of 17 Dutch hospitals.
1,196 invitations for the e-learning course were sent to nursing staff, which included nurses, nursing students and healthcare assistants. Test scores on the final knowledge test (mean 87.4, 95% CI 86.7 to 88.2) were significantly higher than those on baseline (mean 79.3, 95% CI 78.5 to 80.1). At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk. The mean score for this category was 74.3 (95% CI 73.1 to 75.5).
The e-learning course significantly improved nursing staff's knowledge of delirium in all subgroups of participants and for all question categories. Contrary to other studies, the baseline knowledge assessment showed that, overall, nursing staff was relatively knowledgeable regarding delirium.
The Netherlands National Trial Register (NTR).
NTR 2885 , 19 April 2011.
谵妄是住院患者的常见病症，与住院时间延长、功能衰退、死亡率升高以及入住疗养院的比例增加等不良后果相关。护士常常无法识别住院患者的谵妄症状，这可能是由于缺乏谵妄诊断和治疗方面的知识。本研究的目的是测试在线学习课程对护士谵妄知识的有效性，描述护理人员关于谵妄的基线知识，并描述与基线谵妄知识及在线学习课程有效性相关的人口统计学因素。
采用前后对照研究设计，使用关于谵妄的在线学习课程。该课程面向荷兰17家医院内科和外科病房的所有护理人员推出。
共向护理人员发出1196份在线学习课程邀请，其中包括护士、护生和医疗保健助理。最终知识测试的成绩（平均87.4分，95%置信区间86.7至88.2）显著高于基线成绩（平均79.3分，95%置信区间78.5至80.1）。在基线时，护理人员在与谵妄定义相关的问题上遇到的困难最大：谵妄的症状、病程、后果以及哪些患者有风险。这一类别问题的平均分数为74.3分（95%置信区间73.1至75.5）。
在线学习课程显著提高了所有参与亚组护理人员对谵妄的知识水平，且适用于所有问题类别。与其他研究不同，基线知识评估表明，总体而言，护理人员对谵妄的了解程度相对较高。
荷兰国家试验注册库（NTR）。
NTR 2885，2011年4月19日。
