Multimodal Education Program to Improve Nurses' Knowledge and Confidence on Delirium Recognition in a Surgical-Trauma Intermediate-Care Setting

Abstract

BackgroundHigh incidence of delirium in hospitalized patients has been reported in the United States and is significantly associated with increased morbidity and mortality. The lack of knowledge and confidence in performing delirium assessment (KCDA) has led to significant underrecognition of delirium by nurses regardless of evidence-based education intervention.ObjectiveThe purpose of this study was to determine the effectiveness of a multimodal educational program (MEP) to enhance nurses' KCDA.MethodsA MEP including an online didactic with a video-simulation and 1:1 bedside coaching with delirium screening (DS) was conducted in the surgical intermediate-care unit of an academic medical center. A quasi-experimental pre- and post-test design was used.ResultsOf 23 nurses, the majority were <41 years old (73.9%) and had at least a bachelor of science in nursing degree (78.3%) with <6 years of experience (60.9%). The overall KCDA scores and the performance of DS improved significantly after the MEP (p < .001). A positive correlation was noted between the changes of the KCDA scores (p = .009).ConclusionsThe MEP demonstrated improvement in nurses' KCDA. The MEP should focus on an individualized learning approach with a targeted patient population, using current delirium screening tools.Implications for NursingEducational programs are recommended in either an orientation or continuing education program on nursing units. This is also recommended for use in other academic centers that encompass similar clinical settings and could possibly be considered for use in other disease processes.

Effects of a simulation‐based education programme on delirium care for critical care nurses: A randomized controlled trial

“…The current study revealed that delirium care knowledge, confi- combining video simulation and one-on-one bedside coaching with delirium screening was effective (Choi et al, 2020). By adopting a similar approach in our study, we confirmed the effectiveness of implementing a simulation-based education programme in an ICU.…”

“…As the aforementioned literature suggested, simulation‐based education programmes are expected to be effective, and delirium knowledge, confidence and competence are sustained over time after completing simulation‐based education programmes. In particular, a recent quasi‐experimental trial utilized a multimodal delirium care education programme to improve the delirium care knowledge and confidence of surgical nurses, demonstrating that combining video simulation and one‐on‐one bedside coaching with delirium screening was effective (Choi et al, 2020). By adopting a similar approach in our study, we confirmed the effectiveness of implementing a simulation‐based education programme in an ICU.…”

“…The statistic test and model settings for the sample size estimation were as follow: F test as test family; ANOVA: Repeated measures, within factors as statistical test with a prior power analysis (given α , power and effect size) and parameter settings ( α = .05, 1 – β = .95 and f effect size = .3). The parameter settings were established according to previous studies on scenario‐based education programmes with measured competence as an outcome (Choi et al, 2020; Faul et al, 2007). The estimated sample size with an attrition rate of 30% (Hsu et al, 2014) was calculated and 34 participants in each group was considered sufficient.…”