Educational Intervention to Improve Delirium Recognition by Nurses

Delirium poses significantly increased morbidity and mortality for the hospitalized patient. Under-recognition by healthcare providers, especially nurses, contributes to poor patient outcomes. A lack of literature regarding education on the use of the confusion assessment method for the intensive care unit (ICU) (CAM-ICU) delirium screening was noted. The purpose of the project was to evaluate the effectiveness of an educational intervention for medical ICU nurses to improve their knowledge and skills regarding delirium and delirium recognition. An educational intervention was conducted in the MICU of an academic medical center in the south eastern US. Effectiveness was evaluated in a quasi-experimental design using a pre and post assessment. Procedural correctness of the participants performing the CAM-ICU delirium screening was also measured. Thirty-four nurses participated in the sessions from June to September 2016 and completed pre and post assessments. The sample consisted of predominantly BSN-prepared nurses (55.9%) with one to five years of experience (58.8%). Statistical significance (p < .001) was noted in both the overall and knowledge sub-scale mean score differences. The sub-scales of knowledge of tools and scales were not significantly improved by the intervention. Performance of the CAM-ICU was demonstrated as procedurally correct by 79% of participants after the intervention. No pre assessment observations of the CAM-ICU were obtained. The educational intervention conducted for MICU nurses provided additional validation to the literature regarding benefits of an educational program about delirium knowledge. The content of the educational intervention should be targeted for the setting, patient population-specific risk factors, and the specific delirium screening tool used in practice.