University of Virginia, Charlottesville, Virginia
University of Virginia, Charlottesville, Virginia.
J Dr Nurs Pract. 2020 Mar 1;13(1):31-41. doi: 10.1891/2380-9418.JDNP-D-19-00030. Epub 2020 Jan 27.
High incidence of delirium in hospitalized patients has been reported in the United States and is significantly associated with increased morbidity and mortality. The lack of knowledge and confidence in performing delirium assessment (KCDA) has led to significant underrecognition of delirium by nurses regardless of evidence-based education intervention.
The purpose of this study was to determine the effectiveness of a multimodal educational program (MEP) to enhance nurses' KCDA.
A MEP including an online didactic with a video-simulation and 1:1 bedside coaching with delirium screening (DS) was conducted in the surgical intermediate-care unit of an academic medical center. A quasi-experimental pre- and post-test design was used.
Of 23 nurses, the majority were <41 years old (73.9%) and had at least a bachelor of science in nursing degree (78.3%) with <6 years of experience (60.9%). The overall KCDA scores and the performance of DS improved significantly after the MEP ( < .001). A positive correlation was noted between the changes of the KCDA scores ( = .009).
The MEP demonstrated improvement in nurses' KCDA. The MEP should focus on an individualized learning approach with a targeted patient population, using current delirium screening tools.
Educational programs are recommended in either an orientation or continuing education program on nursing units. This is also recommended for use in other academic centers that encompass similar clinical settings and could possibly be considered for use in other disease processes.
美国有报道称住院患者发生谵妄的发生率较高，且与发病率和死亡率的增加显著相关。由于缺乏进行谵妄评估的知识和信心，无论是否进行基于证据的教育干预，护士对谵妄的识别率都显著较低。
本研究旨在确定多模式教育计划（MEP）在提高护士谵妄评估能力（KCDA）方面的有效性。
在学术医疗中心的外科中级护理病房中进行了一项包括在线教学视频模拟和 1:1 床边谵妄筛查（DS）辅导的 MEP。采用准实验前后测试设计。
在 23 名护士中，大多数护士年龄<41 岁（73.9%），至少具有护理学理学学士学位（78.3%），且工作经验<6 年（60.9%）。MEP 后，护士的总体 KCDA 评分和 DS 表现均显著提高（<0.001）。KCDA 评分的变化呈正相关（=0.009）。
MEP 显示出护士 KCDA 的提高。MEP 应侧重于针对特定患者人群的个体化学习方法，并使用当前的谵妄筛查工具。
建议在护理单元的入职培训或继续教育计划中开展教育计划。这也适用于包含类似临床环境的其他学术中心，也可能考虑用于其他疾病过程。
