Literature DB >> 33791762

Cognitive Stimulation in an Intensive Care Unit: A Qualitative Evaluation of Barriers to and Facilitators of Implementation.

Ann M Parker1, Louay Aldabain2, Narges Akhlaghi3, Mary Glover4, Stephanie Yost5, Michael Velaetis6, Annette Lavezza7, Earl Mantheiy8, Kelsey Albert9, Dale M Needham10.   

Abstract

BACKGROUND: Delirium in the intensive care unit is associated with poor patient outcomes. Recent studies support nonpharmacological therapy, including cognitive stimulation, to address delirium. Understanding barriers to cognitive stimulation implemented by nurses during clinical care is essential to translating evidence into practice.
OBJECTIVE: To use qualitative methods through a structured quality improvement project to understand nurses' perceived barriers to implementing a cognitive stimulation intervention in a medical intensive care unit.
METHODS: Data were collected through semistructured interviews with nurses in a medical intensive care unit. Data were categorized into themes by using thematic analysis and the Consolidated Framework for Implementation Research. During cognitive stimulation, nurses reviewed with patients a workbook of evidence-based tasks (focused on math, alertness, motor skills, visual perception, memory, problem-solving, and language).
RESULTS: The 23 nurses identified 62 barriers to and 26 facilitators of cognitive stimulation. These data were summarized into 12 barrier and 9 facilitator themes corresponding to the following Consolidated Framework for Implementation Research domains: Intervention Characteristics, Outer Setting, Inner Setting, and Characteristics of Individuals. Nurses also identified several facilitators within the Process domain. Patient-specific variables, including sedation, were the most frequently reported barriers. Other barriers included cognitive stimulation not being prioritized, nursing staff-related issues, documentation burden, and a lack of understanding of, or appreciation for, the evidence supporting cognitive stimulation.
CONCLUSIONS: Implementation of cognitive stimulation requires a multidisciplinary approach to address perceived barriers arising from the organization, context, and individuals associated with the intervention, as well as the intervention itself. ©2021 American Association of Critical-Care Nurses.

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Year:  2021        PMID: 33791762      PMCID: PMC9528998          DOI: 10.4037/ccn2021551

Source DB:  PubMed          Journal:  Crit Care Nurse        ISSN: 0279-5442            Impact factor:   2.192


  32 in total

1.  Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

Authors:  Allison Tong; Peter Sainsbury; Jonathan Craig
Journal:  Int J Qual Health Care       Date:  2007-09-14       Impact factor: 2.038

2.  Translating evidence into practice: a model for large scale knowledge translation.

Authors:  Peter J Pronovost; Sean M Berenholtz; Dale M Needham
Journal:  BMJ       Date:  2008-10-06

3.  Common Challenges to Effective ABCDEF Bundle Implementation: The ICU Liberation Campaign Experience.

Authors:  Michele C Balas; Brenda T Pun; Chris Pasero; Heidi J Engel; Christiane Perme; Cheryl L Esbrook; Tamra Kelly; Ken D Hargett; Patricia J Posa; Juliana Barr; John W Devlin; Alexandra Morse; Mary Ann Barnes-Daly; Kathleen A Puntillo; J Matthew Aldrich; William D Schweickert; Lori Harmon; Diane G Byrum; Shannon S Carson; E Wesley Ely; Joanna L Stollings
Journal:  Crit Care Nurse       Date:  2019-02       Impact factor: 1.708

4.  Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.

Authors:  John W Devlin; Yoanna Skrobik; Céline Gélinas; Dale M Needham; Arjen J C Slooter; Pratik P Pandharipande; Paula L Watson; Gerald L Weinhouse; Mark E Nunnally; Bram Rochwerg; Michele C Balas; Mark van den Boogaard; Karen J Bosma; Nathaniel E Brummel; Gerald Chanques; Linda Denehy; Xavier Drouot; Gilles L Fraser; Jocelyn E Harris; Aaron M Joffe; Michelle E Kho; John P Kress; Julie A Lanphere; Sharon McKinley; Karin J Neufeld; Margaret A Pisani; Jean-Francois Payen; Brenda T Pun; Kathleen A Puntillo; Richard R Riker; Bryce R H Robinson; Yahya Shehabi; Paul M Szumita; Chris Winkelman; John E Centofanti; Carrie Price; Sina Nikayin; Cheryl J Misak; Pamela D Flood; Ken Kiedrowski; Waleed Alhazzani
Journal:  Crit Care Med       Date:  2018-09       Impact factor: 7.598

Review 5.  The qualitative research interview.

Authors:  Barbara Dicicco-Bloom; Benjamin F Crabtree
Journal:  Med Educ       Date:  2006-04       Impact factor: 6.251

6.  A multicomponent intervention to prevent delirium in hospitalized older patients.

Authors:  S K Inouye; S T Bogardus; P A Charpentier; L Leo-Summers; D Acampora; T R Holford; L M Cooney
Journal:  N Engl J Med       Date:  1999-03-04       Impact factor: 91.245

7.  Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit.

Authors:  E Wesley Ely; Ayumi Shintani; Brenda Truman; Theodore Speroff; Sharon M Gordon; Frank E Harrell; Sharon K Inouye; Gordon R Bernard; Robert S Dittus
Journal:  JAMA       Date:  2004-04-14       Impact factor: 56.272

8.  Effects of an interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) on nursing workload: a pilot study.

Authors:  Manuela Pretto; Rebecca Spirig; Koen Milisen; Sabina Degeest; Pietro Regazzoni; Wolfgang Hasemann
Journal:  Int J Nurs Stud       Date:  2009-02-27       Impact factor: 5.837

9.  The impact of delirium in the intensive care unit on hospital length of stay.

Authors:  E W Ely; S Gautam; R Margolin; J Francis; L May; T Speroff; B Truman; R Dittus; R Bernard; S K Inouye
Journal:  Intensive Care Med       Date:  2001-11-08       Impact factor: 17.440

10.  Interventions for preventing intensive care unit delirium in adults.

Authors:  Suzanne Forsyth Herling; Ingrid E Greve; Eduard E Vasilevskis; Ingrid Egerod; Camilla Bekker Mortensen; Ann Merete Møller; Helle Svenningsen; Thordis Thomsen
Journal:  Cochrane Database Syst Rev       Date:  2018-11-23
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