Nurses' knowledge and perception of delirium screening and assessment in the intensive care unit: Long-term effectiveness of an education-based knowledge translation intervention.

OBJECTIVES

To determine the impact of education on nurses' knowledge of delirium, knowledge and perception of a validated screening tool, and delirium screening in the ICU.

METHODS

A quasi-experimental single group pretest-post-test design.

SETTING

A 16 bed ICU in a Canadian urban tertiary care centre.

MAIN OUTCOME MEASURES

Nursing knowledge and perception were measured at baseline, 3-month and 18-month periods. Delirium screening was then assessed over 24-months.

RESULTS

During the study period, 197 surveys were returned; 84 at baseline, 53 at 3-months post education, and 60 at the final assessment period 18-months post intervention. The significant improvements in mean knowledge scores at 3-months post intervention (7.2, SD 1.3) were not maintained at 18-months (5.3, SD 1.1). Screening tool perception scores remained unchanged. Improvements in the perception of utility were significant at both time periods (p=0.03, 0.02 respectively). Physician value significantly improved at 18-months (p=0.01). Delirium screening frequency improved after education (p<0.001) demonstrating a positive correlation over time (p<0.01).

CONCLUSION

Multifaceted education is effective in improving delirium knowledge and screening; however, without sustained effort, progress is transient. Education improved perceived tool utility and over time utility perception and physician value improved.