Coyle Miriam Anne, Burns Pippa, Traynor Victoria
J Gerontol Nurs. 2017 Apr 1;43(4):29-37. doi: 10.3928/00989134-20170111-02. Epub 2017 Jan 18.
Delirium is characterized by acute and fluctuating cognitive decline, which is often missed in older adults who are assumed to be experiencing age-related changes or dementia. Delirium affects up to 50% of hospitalized older adults. The aim of the current study was to (a) explore current practices of RNs in assessing and identifying delirium in hospitalized older adults and (b) inform new educational initiatives. Qualitative methods were adopted using eight semi-structured group interviews with 24 RNs. Thematic analysis revealed a dichotomy in practice where RNs described delirium assessment and identification as (a) It's Not My Job, (b) It is My Job, and (c) It's Complex. The imperative to improve delirium assessment and identification to create safer and more caring health care environments means the current findings provide important evidence to build into practice and education strategies. The current authors have developed engaging educational interventions and begun implementation at the study site to develop delirium assessment and identification capacity, which moves clinicians beyond awareness and aims at practice adherence or the consistent application of evidence-based delirium assessment. [Journal of Gerontological Nursing, 43(4), 29-37.].
谵妄的特征是急性且波动的认知功能衰退，在被认为正经历与年龄相关变化或痴呆症的老年人中常常被漏诊。谵妄影响着高达50%的住院老年人。本研究的目的是：（a）探究注册护士在评估和识别住院老年人谵妄方面的现行做法；（b）为新的教育举措提供依据。采用定性研究方法，对24名注册护士进行了8次半结构化小组访谈。主题分析揭示了实践中的一种二分法，注册护士将谵妄评估和识别描述为：（a）这不是我的工作；（b）这是我的工作；（c）这很复杂。改善谵妄评估和识别以创造更安全、更具关怀性的医疗环境的紧迫性意味着，当前的研究结果为纳入实践和教育策略提供了重要证据。本文作者已开发出引人入胜的教育干预措施，并开始在研究地点实施，以培养谵妄评估和识别能力，这使临床医生不仅停留在意识层面，而是旨在坚持实践或持续应用基于证据的谵妄评估方法。[《老年护理杂志》，43(4)，29 - 37。]
