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Meghani S, Timmins F. Intensive care nurses' perceptions and awareness of delirium and delirium prevention guidelines. Nurs Crit Care 2024. [PMID: 38634180 DOI: 10.1111/nicc.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Delirium is an acute and fluctuating disturbance of cognition and is a common occurrence in critically ill patients. It is a manifestation of an acute brain dysfunction often attributed to higher survival rates and a subsequently aging population. Intensive Care Unit (ICU) treatment and survival often contributes towards development of delirium, and lack of or inappropriate management can translate into the development of long-term psychological effects that last even after discharge. While a lot is already known about this topic, and several assessment tools exist, these are not being consistently used by ICU nurses and as a result delirium often goes unrecognized, with unwarranted consequences. AIMS The study aimed to explore the perception of delirium among ICU nurses, and the extent of their awareness about guidelines to assess and prevent delirium in ICU patients. It also sought to understand the application of delirium guidelines in ICU practice. STUDY DESIGN A quantitative, exploratory, self-reporting survey was conducted among 145 ICU nurses from one critical care unit in the Republic of Ireland. RESULTS The overall response rate was 71% (103/145). Most nurses (85%) who participated in this survey believed delirium was expected. However, only 45% acknowledged it is a complication. Only 31% of nurses monitored delirium using a validated scale and few observed this as a part of routine care. Most nurses had received education; however, this did not translate to their clinical practice. CONCLUSIONS Guidelines on managing delirium may not be routinely implemented in the ICU settings of hospitals in the Republic of Ireland. RELEVANCE TO CLINICAL PRACTICE As the findings suggest, a gap exists between theory and practice, necessary revision of policy or creating a new policy, supplemental educational sessions such as bedside sessions, e-learning module, study day or seminars need to be organized to improve nurses' awareness related to delirium and delirium prevention guidelines.
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Affiliation(s)
- Salima Meghani
- Department of Pulmonary Hypertension, Mater Hospital, Dublin, Ireland
| | - Fiona Timmins
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Abazid RM, Al-Harbi SA, Allihimy AS, Aldrewesh DA, Alkuraydis SA, Alhammad IM, Elbashir AY, Widyan AM, Abohamr SI. Incidence of delirium in the critical care unit and risk factors in the Central Region, Saudi Arabia. Saudi Med J 2021; 42:445-448. [PMID: 33795502 PMCID: PMC8128631 DOI: 10.15537/smj.2021.42.4.20200754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/22/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: To determine the incidence and risk factors of delirium in the cardiac care unit (CCU) and intensive care unit (ICU). Methods: This multicenter prospective observational study was conducted between July 2019 and November 2019 in the central region of Saudi Arabia. All patients admitted to the critical care units were enrolled, and their demographic data and risk factors of delirium were reported. Results: A total of 165 patients were included: 76 (46.1%) admitted to the CCU and 89 (53.9%) admitted to the ICU. The mean age was 55.1±18 years, and 45 (27.3%) were women. We found that 24/165 (14.5%) patients developed delirium during admission. Importantly, variables significantly associated with delirium group were female gender: (24.5% versus 10.8%, p=0.028), malnutrition (29.2% versus 5%, p<0.001), the presence of urinary catheter (75% versus 30.5%, p=0.001), septicemia (50% versus 14.9%, p<0.001), intubation (41.7% versus 10.6%, p=0.001), low hemoglobin (10.79±2.91 versus 12.05±2.77, p=048), and prolonged prothrombin time (PT) (15.87±5.17 versus 13.60±3.28, p=0.011). Conclusion: The incidence of delirium was 14.5% among patients admitted to critical care units in the central region of Saudi Arabia. Septicemia, prolonged PT, malnutrition, and urinary catheter are significant predictors of delirium.
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Affiliation(s)
- Rami M. Abazid
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
- Address correspondence and reprints request to: Dr. Rami M. Abazid, Division of Nuclear Medicine, Section of Cardiac Hybrid Imaging, Victoria Hospital, London Health Sciences Centre, Ontario, Canada. E-mail: ORCID ID: http://orcid.org/0000-0002-8504-1930
| | - Shaima A. Al-Harbi
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Abdulaziz S. Allihimy
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Dawood A. Aldrewesh
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Sarah A. Alkuraydis
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Ibtihal M. Alhammad
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Ahmed Y. Elbashir
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Adel M. Widyan
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
| | - Samah I. Abohamr
- From the Department of Cardiac Hybrid Imaging (Abazid), Ontario, Canada; from the College of Medicine (Al-Harbi, Allihimy, Aldrewesh, Alkuraydis, Alhammad), Qassim University; from the Department of Mathematics (Widyan), College of Science, Qassim University, Qassim, Buraydah; and from the Department of Cardiology, (Elbashir, Abohamr), Tanta University Hospital, Tanta, Egypt. Heart Health Center (Abohamr), King Saud Medical City. Riyadh, Kingdom of Saudi Arabia.
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