Background and PurposeThis study explored pattern recognition practices of experienced pediatric nurses caring for children with chronic, complex healthcare needs and their families. Nurses worked in the inpatient settings of two different freestanding pediatric hospitals.MethodsMargaret Newman’s theory of Health as Expanding Consciousness (1999) was used to explore the pediatric nurses' experiences. During interviews, participants (n = 8) related their stories in caring for these children and their families. Individual interview data were blended to examine themes.ResultsParticipants described people and events in practice that allowed them to use pattern recognition in the care of children with chronic, complex healthcare needs. Pattern recognition developed in acknowledgement of their past experiences in nursing, as well as with each individual patient and family.Implications for PracticeParticipants had the opportunity to reflect on relationships between their day-to-day practice and their experiences building knowledge and understanding in practice. They considered their abilities to move from skills and tasks to appreciating what each patient and family has taught them about their practice of pattern recognition.

The current integrative review explored the prevalence of delirium among Thai older adults and the role of nurses and physicians in detecting delirium. Several academic databases were searched for relevant studies using a set of predetermined search terms and limits. Study quality was assessed using the National Health and Medical Research Council's Principles of Peer Review. Thirteen studies were reviewed, and three themes were identified: (a) Epidemiology ( n = 9), (b) Detection ( n = 5), and (c) Role of Nurses and Physicians ( n = 4). Higher priority cases were treated for immediate problems by physicians, but they did not routinely screen for delirium, which remained underdiagnosed. Lack of delirium screening guidelines or protocols was found to be the greatest barrier to detection. The ability of nurses to perform delirium screening was disregarded in most studies. There is limited research exploring delirium in Thai older adults, including lack of guidelines or protocols for health care professionals and lack of knowledge of delirium detection, management, and prevention. Further validation of screening tools and developing the training of health care professionals, specific to detecting delirium, is required. [ Journal of Gerontological Nursing, 46 (6), 43–52.]