Travers Catherine, Henderson Amanda, Graham Fred, Beattie Elizabeth
Dementia Collaborative Research Centre, School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove Q 4059, Australia.
Nursing Practice Development Unit, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Qld 4102, Australia.
Nurse Educ Today. 2018 Mar;62:91-97. doi: 10.1016/j.nedt.2017.12.026. Epub 2017 Dec 29.
Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium.
Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium. At the outset, the CogChamps were provided with comprehensive education about dementia and delirium from a multidisciplinary team of clinicians. Their knowledge was assessed to ascertain they had the requisite understanding to engage in education as a collective social process, namely, with each other and their local teams. Following this, they developed ward specific Action Plans in collaboration with their teams aimed at educating and evaluating ward nurses' ability to accurately assess and care for patients for delirium. The plans were implemented over five months. The broader nursing teams' knowledge was assessed, together with their ability to accurately assess patients for delirium.
Each ward implemented their Action Plan to varying degrees and key achievements included the education of a majority of ward nurses about delirium and the certification of the majority as competent to assess patients for delirium using the Confusion Assessment Method. Two wards collected pre-and post-audit data that demonstrated a substantial improvement in delirium screening rates.
The education process led by CogChamps and supported by educators and clinical experts provides an example of successfully educating nurses about delirium and improving screening rates of patients for delirium.
ACTRN 12617000563369.
尽管包括痴呆和谵妄在内的认知障碍在老年住院患者中很常见，但医院工作人员对此并未充分认识或妥善处理，这可能会导致不良事件。本文描述并报告了一种集体社会教育方法对提高护士对谵妄的认识及筛查能力的影响。
来自六个医院病房的34名经验丰富的护士成为认知冠军（CogChamps），带领他们的病房开展关于认知障碍和谵妄评估的集体社会教育过程。一开始，认知冠军们从多学科临床医生团队那里接受了关于痴呆和谵妄的全面教育。对他们的知识进行评估，以确定他们具备作为集体社会过程进行教育的必要理解，也就是与彼此以及当地团队进行教育。在此之后，他们与团队合作制定了病房特定的行动计划，旨在教育和评估病房护士准确评估和护理谵妄患者的能力。这些计划在五个月内实施。对更广泛的护理团队的知识以及他们准确评估谵妄患者的能力进行了评估。
每个病房都不同程度地实施了他们的行动计划，主要成就包括对大多数病房护士进行了谵妄教育，并且大多数护士获得认证，能够使用混乱评估方法对谵妄患者进行评估。两个病房收集了审核前后的数据，这些数据表明谵妄筛查率有了大幅提高。
由认知冠军主导、教育工作者和临床专家支持的教育过程为成功教育护士了解谵妄并提高患者谵妄筛查率提供了一个范例。
ACTRN 12617000563369。
