College of Nursing, Keimyung University, Daegu, Republic of Korea.
College of Nursing, Ajou University, Suwon, Republic of Korea.
Nurs Crit Care. 2024 Sep;29(5):923-930. doi: 10.1111/nicc.13068. Epub 2024 Mar 22.
Delirium commonly occurs in paediatric patients with acute critical illness and negatively affects clinical outcomes. Variations in delirium knowledge levels and its management have been noted among nurses.
This study investigated nurses' experiences and knowledge levels regarding paediatric delirium. Additionally, we aimed to assess the gap between knowledge levels and practical experiences with paediatric delirium.
This cross-sectional descriptive study conveniently sampled paediatric nurses from a university hospital in South Korea between September 2022 and March 2023. Nursing experiences with paediatric delirium and delirium knowledge levels were measured using structured survey questionnaires. Delirium knowledge was scored 0 to 47, and higher scores indicated higher levels of delirium-related knowledge. Data were analysed using descriptive statistics and presented as mean, standard deviation, frequency and percentage.
A total of 127 paediatric nurses participated in this study; 40.2% had experience with 1-5 delirium cases in the previous year, and 86.6% (n = 110) had never used assessment tools for paediatric delirium assessment. The mean total delirium knowledge score was 34.45 ± 5.4; the mean scores of knowledge regarding aetiology, signs and symptoms and nursing management of delirium were 8.93 ± 1.31, 13.24 ± 2.81 and 12.3 ± 2.7, respectively. Interventions associated with a lower level of delirium-related knowledge and a lower performance rate included avoiding restraint use and maintaining hydration and electrolyte levels. Interventions associated with a higher level of delirium-related knowledge but a lower rate of performance comprised providing orientation, offering emotional support, allowing participants to stay with family members and administering medications to manage delirium.
Although nurses working in paediatric units exhibited high rate of delirium nursing care, there was the gap between their delirium-related knowledge and practice. Nurses need to be aware of the insufficient part of delirium care, and paediatric delirium education should be reinforced.
Preventing, assessing and systematically managing paediatric delirium is crucial, and considering the study results, delirium education among nurses is needed.
小儿危重症患者常发生谵妄，对临床结局产生负面影响。护士对谵妄的知识水平和管理存在差异。
本研究调查护士对小儿谵妄的经验和知识水平。此外，我们旨在评估知识水平与小儿谵妄实际经验之间的差距。
本横断面描述性研究于 2022 年 9 月至 2023 年 3 月间在韩国一所大学医院便利抽样选取儿科护士。使用结构化调查问卷测量护士对小儿谵妄的护理经验和谵妄知识水平。谵妄知识评分为 0 至 47 分，得分越高表示与谵妄相关的知识水平越高。使用描述性统计数据进行数据分析，并以均值、标准差、频率和百分比表示。
共有 127 名儿科护士参与了本研究；40.2%（n=51）在过去一年中有 1-5 例谵妄病例的经验，86.6%（n=110）从未使用过小儿谵妄评估工具。总的谵妄知识得分平均为 34.45±5.4；关于病因、体征和症状以及谵妄护理的知识平均得分分别为 8.93±1.31、13.24±2.81 和 12.3±2.7。与较低的谵妄相关知识水平和较低的执行率相关的干预措施包括避免使用约束、保持水合和电解质水平。与较高的谵妄相关知识水平但较低的执行率相关的干预措施包括提供定向、提供情感支持、允许参与者与家属在一起和给予药物治疗以管理谵妄。
尽管在儿科病房工作的护士对谵妄护理的执行率较高，但他们的谵妄相关知识与实践之间存在差距。护士需要意识到谵妄护理的不足部分，加强对儿科谵妄的教育。
预防、评估和系统管理小儿谵妄至关重要，考虑到研究结果，需要对护士进行谵妄教育。
