Original Article 

Assessment of Delirium in Intensive Care Unit Patients: Educational Strategies

Judith M. Smith, PhD, RN, GCNS-BC; M. Nancy Van Aman, DNP, RN, FNP-BC; Mary Elizabeth Schneiderhahn, MSN, RN, ACNS-BC; Robin Edelman, MSN, RN, ACNS-BC; Patrick M. Ercole, PhD, MPH

Abstract

Background:

Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently.

Method:

A pretest–posttest design was used to evaluate the success of a multimodal educational strategy (i.e., online learning module coupled with standardized patient simulation experience) on critical care nurses' knowledge and confidence to assess and manage delirium using the CAM-ICU.

Results:

Participants (N = 34) showed a significant increase (p < .001) in confidence in their ability to assess and manage delirium following the multimodal education. No statistical change in knowledge of delirium existed following the education.

Conclusion:

A multimodal educational strategy, which included simulation, significantly added confidence in critical care nurses' performance using the CAM-ICU.

J Contin Nurs Educ. 2017;48(5):239–244.

Authors

Dr. Smith is Professor, Dr. Van Aman is Assistant Professor, Goldfarb School of Nursing, Barnes-Jewish College; Ms. Schneiderhahn is Critical Care Clinical Nurse Specialist, Critical Care Services, Missouri Baptist Medical Center; Ms. Edelman is Coordinator of Clinical Services, Home Health Care Solutions, St. Louis, Missouri; and Dr. Ercole is Director of Analytics, Sansom Consulting, Glendale, Arizona.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

The authors thank the Medical Executive Committee of Missouri Baptist Medical Center for funding this project. The authors also thank Karen Balakas, PhD, RN, CNE, Research Manager, Center for Quality, Safety, and Practice Excellence, St. Louis Children's Hospital.

Address correspondence to Judith M. Smith, PhD, RN, GCNS-BC, Professor, Goldfarb School of Nursing, Barnes-Jewish College, 4483 Duncan Avenue, Mailstop 90-36-697, St. Louis, MO; e-mail: Jusmith@bjc.org.

Received: December 26, 2015
Accepted: December 06, 2016

10.3928/00220124-20170418-09

Background:

Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently.

Method:

A pretest–posttest design was used to evaluate the success of a multimodal educational strategy (i.e., online learning module coupled with standardized patient simulation experience) on critical care nurses' knowledge and confidence to assess and manage delirium using the CAM-ICU.

Results:

Participants (N = 34) showed a significant increase (p < .001) in confidence in their ability to assess and manage delirium following the multimodal education. No statistical change in knowledge of delirium existed following the education.

Conclusion:

A multimodal educational strategy, which included simulation, significantly added confidence in critical care nurses' performance using the CAM-ICU.

J Contin Nurs Educ. 2017;48(5):239–244.

Dr. Smith is Professor, Dr. Van Aman is Assistant Professor, Goldfarb School of Nursing, Barnes-Jewish College; Ms. Schneiderhahn is Critical Care Clinical Nurse Specialist, Critical Care Services, Missouri Baptist Medical Center; Ms. Edelman is Coordinator of Clinical Services, Home Health Care Solutions, St. Louis, Missouri; and Dr. Ercole is Director of Analytics, Sansom Consulting, Glendale, Arizona.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

The authors thank the Medical Executive Committee of Missouri Baptist Medical Center for funding this project. The authors also thank Karen Balakas, PhD, RN, CNE, Research Manager, Center for Quality, Safety, and Practice Excellence, St. Louis Children's Hospital.

Address correspondence to Judith M. Smith, PhD, RN, GCNS-BC, Professor, Goldfarb School of Nursing, Barnes-Jewish College, 4483 Duncan Avenue, Mailstop 90-36-697, St. Louis, MO; e-mail: Jusmith@bjc.org.

Received: December 26, 2015
Accepted: December 06, 2016
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