Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
권호 표지
DOI QR코드

DOI QR Code

Delirium Screening, Delirium Knowledge, and Delirium Care among Hospital Nurses at a Tertiary Hospital based on Postoperative Delirium Cases

일 상급종합병원 병동간호사의 수술 후 섬망 사례를 이용한 섬망 선별과 섬망 지식 및 섬망 간호

  • Received : 2022.01.31
  • Accepted : 2022.06.24
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to investigate hospital nurses' delirium screening for postoperative delirium, delirium knowledge, and delirium care using case scenarios at a tertiary hospital in Seoul. Methods: A total of 235 nurses working at surgical units participated in this questionnaire-based study. Five cases scenarios were developed based on diagnosed postoperative delirium cases. Data were collected from April 1 to May 1, 2021. Results: The delirium screening score was 4.20±1.17 out of 5. The delirium knowledge score was 34.35±4.57 out of 47. The delirium care score was 67.61±9.26 out of 92. The correlation between the delirium screening and delirium knowledge was statistically significant (r=.18, p=.005). The correlation between the delirium knowledge and delirium care was statistically significant (r=.25, p<.001). Conclusion: The findings showed that the continuing educations of delirium for hospital nurses and the development of a delirium education programs were important to improve delirium screening and care.

Keywords

References

  1. Vlisides PE, Avidan MS. Recent advances in preventing and managing postoperative delirium. F1000Research. 2019;8(F1000 Faculty Rev):607. https://doi.org/10.12688/f1000research.16780.1
  2. Inouye SK, Westendrop RG, Saczynski JS. Delirium in elderly people. The Lancet. 2014;383:911-922. https://doi.org/10.1016/S0140-6736(13)60688-1
  3. Nazemi AK, Gowd AK, Carmouche JJ, Kates SL, Albert TJ, Behrend CJ. Prevention and management of postoperative delirium in elderly patients following elective spinal surgery. Clinical Spine Surgery. 2017;30(3):112-119. https://doi.org/10.1097/BSD.0000000000000467
  4. Oosterhouse KJ, Vincent C, Foreman MD, Gruss VA, Corte C, Berger B. Intensive care unit nurses' beliefs about delirium assessment and management. AACN Advanced Critical Care. 2016;27(4):379-393. https://doi.org/10.4037/aacnacc2016535
  5. Marcantonio ER. Delirium in hospitalized older adults. New England Journal of Medicine. 2017;377(15):1456-1466. https://doi.org/10.1056/NEJMcp1605501
  6. Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in older persons: Advances in diagnosis and treatment. JAMA. 2017;318(12):1161-1174. https://doi.org/10.1001/jama.2017.12067
  7. Flaherty JH, Yue J, Rudolph JL. Dissecting delirium: Phenotypes, consequences, screening, diagnosis, prevention, treatment, and program implementation. Clinics in Geriatric Medicine. 2017;33(3):393-413. https://doi.org/10.1016/j.cger.2017.03.004
  8. Lemiengre J, Nelis T, Joosten E, Braes T, Foreman M, Gastmans C, et al. Detection of delirium by bedside nurses using the confusion assessment method. Journal of the American Geriatrics Society. 2006;54(4):685-689. https://doi.org/10.1111/j.1532-5415.2006.00667.x
  9. Lee YM, Lee BD, Park JM. Clinical implication of delirium subtype. Journal of the Korean Neuropsychiatric Association. 2009;48(3):123-129.
  10. An TH, Ra YS, Han CW, Kim HS, Lee KS, Bae HL. Clinical correlates of subtype and severity in patients with delirium. Journal of Korean Neuropsychiatric Association. 2015;54(4):489-494. https://doi.org/10.4306/jknpa.2015.54.4.489
  11. van Velthuijsen EL, Zwakhalen SM, Mulder WJ, Verhey FR, Kempen GI. Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: A retrospective cohort study evaluating daily practice. International Journal of Geriatric Psychiatry. 2018;33(11):1521-1529. https://doi.org/10.1002/gps.4690
  12. Choi EJ, Lee HJ, Kim IA, Lim YJ, Lee MS, Kim MJ. Delirium assessment ability of clinical nurses. Journal of Korean Gerontological Nursing. 2011;13(3):233-241. UCI: G704-SER000008641.2011.13.3.007
  13. Park HM, Chang MY. Nurse's knowledge, confidence and performance on care for delirium. Journal of Health Informatics and Statistics. 2016;41(4):359-368. https://doi.org/10.21032/jhis.2016.41.4.359
  14. Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalized patients: The nursing delirium screening scale. Journal of Pain and Symptom Management. 2005;29(4):368-375. https://doi.org/10.1016/j.jpainsymman.2004.07.009
  15. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. (DSM-5®). Washington (DC): American Psychiatric Association; 2013. p. 1-991. https://doi.org/10.1176/appi.books.9780890425596
  16. Mulkey MA, Roberson DW, Everhart DE, Hardin SR. Choosing the right delirium assessment tool. Journal of Neuroscience Nursing. 2018;50(6):343-348. https://doi.org/10.1097/JNN.0000000000000403
  17. Wong CL, Holroyd-Leduc J, Simel DL, Straus SE. Does this patient have delirium?: Value of bedside instruments. JAMA. 2010;304(7):779-786. https://doi.org/10.1001/jama.2010.1182
  18. Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y. Intensive care delirium screening checklist: Evaluation of a new screening tool. Intensive Care Medicine. 2001;27(5):859-864. https://doi.org/10.1007/s001340100909
  19. van Velthuijsen EL, Zwakhalen SM, Warnier RM, Mulder WJ, Verhey FR, Kempen GI. Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: A systematic review. International Journal of Geriatric Psychiatry. 2016;31(9):974-989. https://doi.org/10.1002/gps.4441
  20. Neelon VJ, Champagne MT, Carlson JR, Funk SG. The NEECHAM Confusion Scale: Construction, validation, and clinical testing. Nursing Research. 1996;45(6):324-330. https://doi.org/10.1097/00006199-199611000-00002
  21. Marcantonio ER. Postoperative delirium: A 76-year-old woman with delirium following surgery. JAMA. 2012;308(1):73-81. https://doi.org/10.1001/jama.2012.6857
  22. Kim KN, Kim CH, Kim KI, Yoo HJ, Park SY, Park YH. Development and validation of the Korean Nursing Delirium Scale. Journal of Korean Academy of Nursing. 2012;42(3):414-423. https://doi.org/10.4040/jkan.2012.42.3.414
  23. Park YS, Gu MO. The development and effects of evidence-based nursing practice guideline for cancer patients with delirium. Evidence and Nursing. 2013;1(1):4-15. https://doi.org/10.54003/kebn.2013.1.1.4
  24. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41:1149-1160. https://doi.org/10.3758/brm.41.4.1149
  25. Cho GL. ICU Nurses' knowledge and nursing performance of intensive care unit syndrome [master's thesis]. Seoul: Ewha Womans University; 2001. p. 1-52.
  26. Suh HJ, Yoo YS. Intensive care unit nurse's knowledge, nursing performance, and stress about delirium. Korean Journal of Adult Nursing. 2007;19(1):55-65. UCI: G704-000678.2007.19.1.013 G704-000678.2007.19.1.013
  27. Park HM, Chang MY. Influence of nurse's knowledge, confidence on nursing performance of delirium. Journal of Health Informatics and Statistics. 2016;41(4):359-368. https://doi.org/10.21032/jhis.2016.41.4.359
  28. Oh IS, Kim JH. Impacts of critical thinking disposition and nursing work environment on nurses' clinical decision making abilities. Journal of Korean Academic Society of Nursing Education. 2016:22(3);304-315. https://doi.org/10.5977/jkasne.2016.22.3.304