Date of Award

2010

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Rebecca Beck-Little

Abstract

Delirium has a tremendous impact on the patient, his family, and the health care system. In particular, the elderly patient in the Intensive Care Unit is the most susceptible to this condition. Delirium often results in longer hospital stays, more Intensive Care days, increased likelihood of being placed in a skilled nursing facility, and increases in mortality. For delirium to be treated properly it must first be identified. Critical care nurses are in the best position to identify these patients and initiate treatment. Past studies have shown that nurses do not identify patients that have delirium, and do not know the best way to intervene for these patients (Hare, McGowan, Wynaden, Speed, Landsborough, 2008; Inouye et al., 1999). This study examined the practices and perceptions that critical care nurses have toward delirium as compared to sedation assessment. Sedation assessment was chosen as a comparison due to its widespread acceptance and use in the critical care community.

A paper/Web based survey was distributed to critical care RN's by the "snowball" method. Twenty surveys were obtained from the Charlotte and Shelby, North Carolina areas. The results of the survey showed that no respondents ranked delirium assessment as the most important item to assess and 40% of respondents ranked it as last. Sixty percent of respondents received no education about delirium assessment. Education of sedation assessment was more common with all respondents reporting at least some form of education received. This study also found that there were many misconceptions that nurses possessed concerning delirium assessment. Sixty five percent of nurses did not agree that delirium is associated with an increase in mortality which has been shown in multiple studies.

In conclusion the study showed that nurses lacked the knowledge and tools to be able to complete delirium assessment on their patient. The purpose of this study was to identify the practices and perceptions of critical care nurses as related to delirium assessment and subsequently be able to design an educational program to meet these needs.

Share

COinS