Department of Nursing Research, University Hospital of Schleswig-Holstein, Campus Kiel, Brunswiker Str. 10, Kiel, Germany.
Department of Critical Care, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg.
Nurs Crit Care. 2018 Jan;23(1):23-29. doi: 10.1111/nicc.12299. Epub 2017 May 18.
Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines.
To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians.
The study used an open online survey with multiple-choice responses.
An invitation for participation was spread via journals and electronic resources using a snowball system. Apart from recording socio-demographical characteristics, the survey collected data on delirium assessment, delirium-related processes, non-pharmacological prevention and treatment and barriers for implementation. Differences between nurses and physicians were tested by Fisher's exact test with sequential Bonferroni correction.
The survey was conducted in autumn 2016, and 559 clinicians participated. More nurses than physicians reported screening for delirium. The majority of clinicians reported screening for delirium when this was suspected; more than 50% used validated instruments. Half of the clinicians had delirium-related structures implemented, such as two thirds reporting delirium-related processes. Most cited barriers were lack of time and missing knowledge about delirium and its assessment. With significant difference, physicians recommended more than nurses early removal of catheters and daily interprofessional goals for patients.
In German-speaking countries, assessment of delirium needs further improvement, leading to accurate assessment. Delirium-related structures and processes appear to be implemented widely, with only a few differences between nurses and physicians.
Nurses and physicians in this survey reported similar perceptions and attitudes towards management of delirium. Both professions need more knowledge and inter-professional training on when and how to use validated assessment instruments.
谵妄是重症监护病房患者的严重并发症。先前对日常实践中谵妄管理的调查显示，发表的指南遵循率较低。
评估德语国家重症监护病房护士和医生对谵妄的管理情况，并确定护士和医生之间的相关差异。
本研究采用了在线开放式多项选择调查。
通过期刊和电子资源使用滚雪球系统传播参与邀请。除了记录社会人口统计学特征外，调查还收集了谵妄评估、谵妄相关流程、非药物预防和治疗以及实施障碍的数据。护士和医生之间的差异用 Fisher 确切检验和连续 Bonferroni 校正进行检验。
该调查于 2016 年秋季进行，共有 559 名临床医生参与。报告筛查谵妄的护士多于医生。大多数临床医生在怀疑有谵妄时报告进行筛查；超过 50%的人使用了经过验证的工具。一半的临床医生实施了与谵妄相关的结构，例如三分之二的人报告了与谵妄相关的流程。最常提到的障碍是缺乏时间和对谵妄及其评估的知识。与护士相比，医生建议更多地早期去除导管和为患者制定每日跨专业目标，这具有显著差异。
在德语国家，需要进一步改进谵妄评估，以实现准确评估。与谵妄相关的结构和流程似乎得到了广泛的实施，护士和医生之间只有很少的差异。
本调查中的护士和医生对谵妄管理的看法和态度相似。这两个专业都需要更多关于何时以及如何使用经过验证的评估工具的知识和跨专业培训。
