Department of Internal and Pediatric Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland.
Department of Anaesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland.
Front Public Health. 2023 Mar 3;11:1119526. doi: 10.3389/fpubh.2023.1119526. eCollection 2023.
Delirium is a cognitive disorder that occurs with high frequency in patients in intensive care units and affects patient outcomes. Despite recommendations for monitoring and assessing delirium in the ICU, studies show that it is still not routinely assessed and often remains undiagnosed or misinterpreted as dementia or depression.
The aim of this study was (1) to assess nurses' knowledge and clinical practices regarding delirium, (2) to identify the factors associated with nurses' knowledge, and (3) to define barriers to effective control of delirium.
A cross-sectional study was conducted among 371 ICU nurses in Poland.
53.1% of nurses had never been educated on delirium control resulting in a deficit in knowledge of delirium symptoms, risk factors and complications associated with delirium in ICU patients. Master's degree in nursing (vs. Registered nurses + Bachelor's), female gender, and working in university hospital (vs. other) were positively correlated with nurse's knowledge, while age had a negative impact on knowledge. Delirium is a marginalized state in ICU patients, only 16.4% of nurses assessed delirium routinely and 35.8% assessed delirium occasionally, rarely using validated scales. Barriers to effective delirium control were primarily the lack of a requirement to assess delirium, the difficulty of assessing delirium in intubated patients and nurses' lack of confidence in their ability to use delirium assessment tools.
There is an urgent need to educate nurses about delirium and to make delirium assessment obligatory in clinical practice. The area of change should also include a hospital policy on delirium monitoring and management. The study was registered on ClinicalTrials.gov (NCT05384964).
谵妄是一种在重症监护病房患者中高频发生的认知障碍，会影响患者的预后。尽管有建议监测和评估 ICU 中的谵妄，但研究表明，它仍未得到常规评估，往往仍未被诊断或被误诊为痴呆或抑郁症。
本研究旨在：(1)评估护士对谵妄的知识和临床实践；(2)确定与护士知识相关的因素；(3)确定有效控制谵妄的障碍。
在波兰对 371 名 ICU 护士进行了横断面研究。
53.1%的护士从未接受过谵妄控制方面的教育，导致对 ICU 患者谵妄症状、风险因素和并发症的知识存在缺陷。护理硕士（相对于注册护士+学士）、女性和在大学医院工作（相对于其他）与护士的知识呈正相关，而年龄对知识有负面影响。谵妄在 ICU 患者中处于边缘化状态，只有 16.4%的护士常规评估谵妄，35.8%偶尔评估谵妄，很少使用经过验证的量表。有效控制谵妄的障碍主要是缺乏评估谵妄的要求、评估插管患者谵妄的难度以及护士对使用谵妄评估工具的能力缺乏信心。
迫切需要对护士进行谵妄教育，并在临床实践中强制评估谵妄。需要改变的领域还应包括医院对谵妄监测和管理的政策。该研究已在 ClinicalTrials.gov 上注册（NCT05384964）。
