Zuo Ling-Ling, He Shan, He Guan-Feng, Zuo Ze-Lan, Liao Min
Department of PICU Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Nurs Crit Care. 2025 Jul;30(4):e70083. doi: 10.1111/nicc.70083.
Delirium, a common complication in paediatric intensive care units (PICUs), can significantly impede recovery and lead to adverse outcomes. The Cornell Assessment of Pediatric Delirium (CAPD) scale, a subjective tool for delirium identification, is influenced by nurses' clinical expertise and cognitive abilities. Therefore, targeted education and training for health care providers are essential.
This study aimed to enhance PICU nurses' ability to assess paediatric delirium through a Multimodal Educational Programme based on the PRECEDE (Predisposing, Reinforcing and Enabling Causes in Educational Diagnosis and Evaluation) model.
A descriptive quantitative study with a pretest-post-test design was conducted. Sixty-five PICU nurses participated in a one-month training programme on paediatric delirium. Training effectiveness was evaluated using the "Nurses' Knowledge, Attitudes, and Behavior Survey on Pediatric Delirium," the "CAPD Competency Test," and clinical data from CAPD scale usage.
Post-training, nurses demonstrated significant improvements in knowledge (95% CI [1.002, 3.518], p < 0.01), attitudes (95% CI [0.344, 3.036], p < 0.05) and behaviours (95% CI [1.806, 5.094], p < 0.001) related to paediatric delirium. Proficiency in using the CAPD scale also improved significantly (t = -18.453, 95% CI [6.892, 8.308], p < 0.001). Inter-rater consistency increased from 66.12% to 87.31% (p < 0.05).
The PRECEDE model-based training programme effectively enhanced nurses' knowledge, attitudes and behaviours regarding paediatric delirium and improved their assessment skills. Future studies should collect data on delirium incidence to determine whether the training reduces paediatric delirium occurrence.
This training programme promotes more accurate paediatric delirium assessment using the CAPD scale, thereby improving inter-rater consistency among PICU nurses.
谵妄是儿科重症监护病房（PICU）常见的并发症，会显著阻碍康复并导致不良后果。康奈尔儿科谵妄评估（CAPD）量表是一种用于识别谵妄的主观工具，受护士临床专业知识和认知能力的影响。因此，对医疗保健人员进行有针对性的教育和培训至关重要。
本研究旨在通过基于PRECEDE（教育诊断与评价中的诱发、强化和促成因素）模型的多模式教育计划，提高PICU护士评估儿科谵妄的能力。
采用前后测设计进行描述性定量研究。65名PICU护士参加了为期一个月的儿科谵妄培训计划。使用“护士关于儿科谵妄的知识、态度和行为调查”、“CAPD能力测试”以及CAPD量表使用的临床数据对培训效果进行评估。
培训后，护士在与儿科谵妄相关的知识（95%可信区间[1.002, 3.518]，p < 0.01）、态度（95%可信区间[0.344, 3.036]，p < 0.05）和行为（95%可信区间[1.806, 5.094]，p < 0.001）方面有显著改善。使用CAPD量表的熟练程度也有显著提高（t = -18.453，95%可信区间[6.892, 8.308]，p < 0.001）。评分者间一致性从66.12%提高到87.31%（p < 0.05）。
基于PRECEDE模型的培训计划有效提高了护士关于儿科谵妄的知识、态度和行为，并改善了他们的评估技能。未来的研究应收集谵妄发生率的数据，以确定该培训是否能降低儿科谵妄的发生率。
该培训计划促进了使用CAPD量表对儿科谵妄进行更准确的评估，从而提高了PICU护士之间的评分者间一致性。
