A qualitative study on experience of nurses caring for patients with delirium in ICUs in China: Barriers, burdens and decision making dilemmas

Yue, Peng; liu, chang; Wu, Ying

doi:10.1016/j.ijnss.2015.01.014

Cited by 22 publications

(46 citation statements)

References 32 publications

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“…This finding was similar to the study conducted in Jordan by Hamdan-Mansour et al 2 and Yue et al 8 Another study suggested that comprehensive educational programs were needed to decrease accident related to ICU syndrome and to improve the health of ICU patients.…”

supporting

confidence: 90%

Knowledge on Intensive Care Delirium among Nurses at Hospital, Nepal

Shrestha¹,

Shrestha²

2017

IJNRP

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Abstract:Introduction: The number of intensive care units and people in them is growing and intensive care unit delirium is increasing as a problem. It is a common acute organic brain dysfunction characterized by disturbance of consciousness and cognition. It is preventable and potentially reversible condition commonly seen in critically ill patients. Objectives:The aim of this study was to assess knowledge on intensive care unit delirium among nurses working in critical care unit at Tribhuvan University Teaching Hospital, Kathmandu.Methodology: This descriptive cross sectional study was undertaken at Tribhuvan University Teaching Hospital (TUTH), Kathmandu. Period of data collection was for two months. Eighty five nurses working in critical care unit participated in the study and self-administered questionnaire was used and non-probability, purposive sampling technique was used for data collection.Results: Among 85 respondents, more than half (65.9%) had moderate knowledge, more than one quarter (34.1%) had poor knowledge and none of the respondents had good knowledge. There was a significant association between work experience (p=0.010) and in-service training (p=0.001) with knowledge. However, there was no association between age, education level and knowledge of respondents. Conclusion:The study revealed that the nurses had moderate to low level of knowledge on intensive care unit delirium. There was statistically significant association between work experience, in-service education or training and knowledge on ICU delirium.

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confidence: 90%

Knowledge on Intensive Care Delirium among Nurses at Hospital, Nepal

Shrestha¹,

Shrestha²

2017

IJNRP

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“…Patients with hyperactive delirium are unpopular amongst nurses (Williams, ). Failure to engage with delirious patients may stem from the challenge these patients present to the bedside nurse (Mc Donnell & Timmins, ; Yue, Wang, Liu, & Wu, ; Zamoscik et al, ). Staff report experiences of emotional and physical exhaustion stemming from caring for delirious patients, especially over long shifts (Yue et al, ).…”

Section: Discussionmentioning

confidence: 99%

Identifying determinants for the application of physical or chemical restraint in the management of psychomotor agitation on the critical care unit

Teece

Baker

Smith

2019

Journal of Clinical Nursing

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Aims and objectives To identify key determinants, which lead to the decision to apply physical or chemical restraint on the critical care unit. Background Psychomotor agitation and hyperactive delirium are frequently cited as clinical rationale for initiating chemical and physical restraint in critical care. Current restraint guidance is over a decade old, and wide variations in nursing and prescribing practice are evident. It is unclear whether restraint use is grounded in evidence‐based practice or custom and culture. Study design Integrative review. Method Seven health sciences databases were searched to identify published and grey literature (1995–2019), with additional hand‐searching. The systematic deselection process followed PRISMA guidance. Studies were included if they identified physical or chemical restraint as a method of agitation management in adult critical care units. Quality appraisal was undertaken using Mixed Methods Appraisal Tool. Data were extracted, and thematic analysis undertaken. Results A total of 23 studies were included. Four main themes were identified: the lack of standardised practice, patient characteristics associated with restraint use, the struggle in practice and the decision to apply restraint. Conclusions There are wide variations in restraint use despite the presence of international guidance. Nurses are the primary decision‐makers in applying restraint and report that caring for delirious patients is physically and psychologically challenging. The decision to restrain can be influenced by the working environment, patient behaviours and clinical acuity. Enhanced clinical support and guidance for nurses caring for delirious patients is indicated. Relevance to clinical practice Delirium and agitation pose a potential threat to patient safety and the maintenance of life‐preserving therapies. Restraint is viewed as one method of preserving patient safety. However, use appears to be influenced by previous adverse experiences and subjective patient descriptors, rather than robust evidence‐based knowledge. The need for a precise language to describe restraint and quantify when it becomes necessary is indicated.

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“…Also, Yue, et al, [20] who stated lack of knowledge and skills required to assess and manage the delirium patients lead to preventing nurses from recognizing early symptoms. As well as Trogrlic et al, [21] who made a survey among intensive care unit professionals about their attitude, knowledge and practices concerning delirium, the study indicated that knowledge deficit were presented more clearly in nurses than in physicians.…”

Section: Discussionmentioning

confidence: 99%

“…This results contradicted with [21] who founded that The majority of the respondents were frequently performed promotion of day time wakefulness (81%), use of glasses when patients are visually impaired (74%) and use of hearing aids when patients are hearing impaired (67%). However, Yue et al, [20] explained unsatisfactory delirium practice from the side of nurses resulting from the lack of knowledge, absence of evidence-based nursing practice, complex symptoms, and changing shifts which leads to difficulties in detecting the early delirium signs.…”

Section: Discussionmentioning

confidence: 99%

Learning Needs Assessment of Pediatric Nurses Regarding Delirium and Its Barriers of Screening at Intensive Care Units

Abusaad¹,

Mostafa²,

Ibraheim³

2017

AJNR

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Pediatric delirium is a significant issue among critically ill children; Professional and highly qualified nurses are usually the first who identify delirium in ICU patients, with a need for close monitoring, recognition, and prevention. Aim of the study was to assess learning needs of critical care nurses regarding pediatric delirium and its barrier of screening at ICUs. Method: A descriptive design was conducted on a purposive sample of 91 pediatric critical care nurses working at Mansoura University Children's hospital and New Mansoura General hospital who fulfills the criteria of selection using pediatric nurses learning needs structured questionnaire that includes questions about characteristics of studied nurses, nurse's knowledge, attitude and practice about pediatric delirium and barriers of delirium screening among pediatric critical care nurses. Results: the level of nurses' knowledge was poor in 94.5%, fair in 5.5% and there was any one with good knowledge, the negative attitude toward delirium was reported in 54.9% of nurses, while only 3.3% of nurses has positive attitude and the level of practice was unsatisfactory in 81.3% of nurses. The most common barriers for delirium screening as reported by the studied nurses is absent of tool to evaluate delirium (86.8%), difficult to determine delirium in children on ventilator (78.0%) and inefficient of symptoms registering in children taking sedation (70.3%). Conclusions: the majority of studied nurses have poor knowledge about pediatric delirium particularly for its definition, causes and its management. Also, more than half of them has negative attitude regarding delirium and majority of them has unsatisfactory practice. The commonest barriers for delirium screening were absent of tool and difficulties of delirium screening for children on ventilator at ICUs. Recommendation: pediatric critical care nurses learning needs should be assessed constantly and progressively through implementing educational training program to increase competences of Pediatric ICUs staff focused on practical guidelines for hospitalized children with delirium.

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A qualitative study on experience of nurses caring for patients with delirium in ICUs in China: Barriers, burdens and decision making dilemmas

Cited by 22 publications

References 32 publications

Knowledge on Intensive Care Delirium among Nurses at Hospital, Nepal

Knowledge on Intensive Care Delirium among Nurses at Hospital, Nepal

Identifying determinants for the application of physical or chemical restraint in the management of psychomotor agitation on the critical care unit

Learning Needs Assessment of Pediatric Nurses Regarding Delirium and Its Barriers of Screening at Intensive Care Units

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