Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
College of Nursing, University of Cincinnati, Cincinnati, OH.
Pediatr Crit Care Med. 2018 Jun;19(6):538-543. doi: 10.1097/PCC.0000000000001558.
The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery.
Descriptive self-report survey.
A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society.
Pediatric cardiac intensive care clinicians (physicians and nurses).
None.
One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia.
Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.
本研究旨在描述儿科心脏重症监护临床医生如何评估和管理心脏手术后患者的谵妄。
描述性自我报告调查。
儿科心脏重症监护学会成员的儿科心脏重症监护临床医生的在线调查。
儿科心脏重症监护临床医生（医生和护士）。
无。
来自 13 个国家 71 家不同机构的 173 名临床医生完成了调查。受访者描述他们对谵妄发生的临床印象约为 25%。大多数受访者（75%）报告说，他们的 ICU 没有常规筛查谵妄。超过一半的受访者（61%）从未参加过关于谵妄的讲座。大多数受访者（86%）对当前的谵妄筛查、诊断和管理实践不满意。促进日夜循环、暴露于自然光、减少护理强度、睡眠卫生以及定向以预防或管理谵妄是报告的非药物干预措施之一，同时还使用了抗焦虑药、抗精神病药和治疗失眠的药物。
对调查做出回应的临床医生报告了一系列术后儿科心脏手术患者的谵妄评估和管理实践。研究结果强调了需要改善儿科心脏重症监护临床医生的谵妄教育，以及需要对当前的谵妄评估和管理实践进行系统评估。
