How effective are General Nurses in recognising and preventing delirium in hospitalised patients?

Abstract

The literature indicates that delirium is a common problem among hospitalized patients in the acute hospital settings. The prevalence of delirium is reported to be 20-30% on medical wards within the acute setting (NICE, 2010). It is also reported by the HSE (2015) that it is being missed up to 67% of the time. METHODS: The study design was a descriptive cross-sectional survey of practicing nurses in the general ward setting, using an anonymized questionnaire. The questionnaire was divided into two sections, part A provided demographic characteristics and part B provided the level of knowledge the nurse will demonstrate on delirium. RESULTS: The questionnaire had a completion rate of 75% of the target population. Both electronic 30% and paper versions 70% of the questionnaire were used. Professional status was broken into three sections, Staff Nurse 62%, Nurse Specialist 17% and Nursing Management 21%. Years of experience was segregated into four sections, 0-5 years (9%), 6-10 years (10%), 11-20 years (43%) and finally 20 years or greater (38%). The participant’s level of knowledge on delirium was assessed by the 69 questions. The scores attained by the nurses from the knowledge questionnaire regarding delirium varied from 0 the lowest to 60 the highest, 41.31 +/- 12.883 being the average score. Scores were also viewed from professional status. Staff nurses (n=65) had a mean score of 41.25, +/- 13.552, Nurse Specialist Group (n=18) had a mean score of 42.83, +/- 12.803 and Nursing Management (n=22) had a mean score of 40.27, +/- 12.803. CONCLUSION: This under-recognition, along with increasing evidence regarding delirium treatment opinions emphasises the importance of a prompt accurate diagnosis. Improving delirium assessment to ensure early identification is critical for timely and effective management, yet delirium prevention, screening, recognition, and treatment are challenging for all levels of nurses.