Peter Nydahl1, Michael Dewes2, Rolf Dubb3, Carsten Hermes4, Arnold Kaltwasser5, Susanne Krotsetis6, Rebecca von Haken7. 1. Department of Nursing Research, University Hospital of Schleswig-Holstein, Campus Kiel, Brunswiker Str. 10, Kiel, Germany. 2. Department of Critical Care, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg. 3. Nursing Education District Hospital of Reutlingen GmbH, Reutlingen, Germany. 4. Siegburg-Bonn, Germany. 5. Nursing Education, District Hospital of Reutlingen GmbH, Reutlingen, Germany. 6. Department of Nursing Research, University Hospital of Schleswig-Holstein, Campus Lübeck, Germany. 7. Department of Anesthesia and Critical Care, University Hospital Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. AIM: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. DESIGN: The study used an open online survey with multiple-choice responses. METHODS: An invitation for participation was spread via journals and electronic resources using a snowball system. Apart from recording socio-demographical characteristics, the survey collected data on delirium assessment, delirium-related processes, non-pharmacological prevention and treatment and barriers for implementation. Differences between nurses and physicians were tested by Fisher's exact test with sequential Bonferroni correction. RESULTS: The survey was conducted in autumn 2016, and 559 clinicians participated. More nurses than physicians reported screening for delirium. The majority of clinicians reported screening for delirium when this was suspected; more than 50% used validated instruments. Half of the clinicians had delirium-related structures implemented, such as two thirds reporting delirium-related processes. Most cited barriers were lack of time and missing knowledge about delirium and its assessment. With significant difference, physicians recommended more than nurses early removal of catheters and daily interprofessional goals for patients. CONCLUSION: In German-speaking countries, assessment of delirium needs further improvement, leading to accurate assessment. Delirium-related structures and processes appear to be implemented widely, with only a few differences between nurses and physicians. RELEVANCE TO CLINICAL PRACTICE: Nurses and physicians in this survey reported similar perceptions and attitudes towards management of delirium. Both professions need more knowledge and inter-professional training on when and how to use validated assessment instruments.
BACKGROUND:Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. AIM: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. DESIGN: The study used an open online survey with multiple-choice responses. METHODS: An invitation for participation was spread via journals and electronic resources using a snowball system. Apart from recording socio-demographical characteristics, the survey collected data on delirium assessment, delirium-related processes, non-pharmacological prevention and treatment and barriers for implementation. Differences between nurses and physicians were tested by Fisher's exact test with sequential Bonferroni correction. RESULTS: The survey was conducted in autumn 2016, and 559 clinicians participated. More nurses than physicians reported screening for delirium. The majority of clinicians reported screening for delirium when this was suspected; more than 50% used validated instruments. Half of the clinicians had delirium-related structures implemented, such as two thirds reporting delirium-related processes. Most cited barriers were lack of time and missing knowledge about delirium and its assessment. With significant difference, physicians recommended more than nurses early removal of catheters and daily interprofessional goals for patients. CONCLUSION: In German-speaking countries, assessment of delirium needs further improvement, leading to accurate assessment. Delirium-related structures and processes appear to be implemented widely, with only a few differences between nurses and physicians. RELEVANCE TO CLINICAL PRACTICE: Nurses and physicians in this survey reported similar perceptions and attitudes towards management of delirium. Both professions need more knowledge and inter-professional training on when and how to use validated assessment instruments.
Authors: Susanne Krotsetis; Peter Nydahl; Rolf Dubb; Carsten Hermes; Arnold Kaltwasser; Rebecca von Haken Journal: Intensive Care Med Date: 2017-09-22 Impact factor: 17.440
Authors: Peter Nydahl; Friederike Baumgarte; Daniela Berg; Manuela Bergjan; Christoph Borzikowsky; Christiana Franke; Diana Green; Anisa Hannig; Hans Christian Hansen; Armin Hauss; Uta Hansen; Rahel Istel; Norma Krämer; Karita Krause; Renée Lohrmann; Mohammad Mohammadzadeh-Vazifeh; Jürgen Osterbrink; Frederick Palm; Telse Petersen; Bernd Schöller; Henning Stolze; Max Zilezinski; Johannes Meyne; Nils G Margraf Journal: J Neurol Date: 2022-02-14 Impact factor: 6.682
Authors: Kiki R Buijs-Spanjers; Anne Harmsen; Harianne H Hegge; Jorinde E Spook; Sophia E de Rooij; Debbie A D C Jaarsma Journal: BMC Med Educ Date: 2020-09-01 Impact factor: 2.463