Perceptions, attitudes, and current practices regards delirium in China

Abstract

The purpose of this study is to assess the knowledge, attitudes, and managements regarding delirium of intensive care nurses and physicans, and to assess the perceived barriers related to intensive care unit (ICU) delirium monitoring in China. A descriptive survey was distributed to 1156 critical care nurses and physicians from 74 tertiary and secondary hospitals across Shandong province, China. The overall response rate was 86.18% (n = 917). The majority of respondents (88%) believed that deirium was associated with prolonged mechanical ventilation, and 79.72% thought delirium was associated with prolonged length of hospitalization. Only 14.17% of respondents believed that delirium was common in the ICU setting. Only 25.62% of the respondents reported routine screening of ICU delirium, and only 15.81% utilized Confusion Assessment Method for Intensive Care Unit screening tools. “Lack of appropriate screening tools” and “time restraints” were the most common perceived barriers. 45.4% of the participants had never received any education on ICU delirium. In conclusion, most nurses and physicians consider ICU delirium to be a serious problem, but lack knowledge on delirium and monitor this condition poorly. The survey infers a disconnection between the perceived significance and current monitoring of ICU delirium. There is a critical unmet need for in-service education on ICU delirium for physicians and nurses in China.

<p>Risk factors for delirium: are therapeutic interventions part of it?</p>

“…The comparison of these continuous variables was done using Wilcoxon rank-sum test for nonparametric data. For categorical variables, descriptions were used frequencies and proportions, and Pearson’s chi-square ( X 2 test ) was used for comparisons between the delirious and non-delirium group. Multivariate logistic regression analysis was used to assess the association of potential covariates with delirium.…”

“…Delirium is an acute fluctuating change in mental status with attentional deficits and disorganized behavior. The prevalence of delirium ranges from 20% to 80% in critical ill patients in the intensive care unit (ICU) 1,2. Delirium is related with higher mortality, prolonged hospitalization, larger hospital costs, cognitive decline, and potential functional disability 3–8…”

Enfermería en la monitorización del delirium en cuidado intensivo adulto: una revisión de alcance

“…Este estudio reveló que más del 60% de los enfermeros evalúan de forma rutinaria el delirium, aunque el empleo de instrumentos validados en la práctica es poco. Esto no coindice con lo descrito por Selim y Ely (32) y Xing et al (33), donde solo el 26.8% y el 25.62% de los profesionales de la UCI, respectivamente, evalúan el delirium de manera rutinaria (32,33). Sin embargo, sí se reconoce por Tostes et al (34), que los profesionales de la salud no utilizaron herramientas estandarizadas, y se basaron en su juicio clínico y experiencia.…”

“…Las herramientas más utilizadas para la detección por enfermería son la Nu-DESC, el CAM-ICU y el ICDSC, esto corresponde a lo reportado en otros estudios, donde se arma que los profesionales emplean la CAM-ICU y el ICDSC como principales herramientas de detección (33,35), aunque también emplean otras estrategias como observación de la agitación y la consulta psiquiátrica (35).…”

Implementation of the PADIS 2018 Guidelines: a National Multicenter Survey in the Adults Intensive Care Units in Mainland China

“…The mass data had a wide coverage and re ected the true situation of medical staff's self-evaluation in adult ICU. A previous review of studies (10)(11)(12) in China presented that the medical staff had improved compliance with the guidelines, irrespective of the assessment and management of sedation, analgesia, or delirium, but there were still some shortcomings.…”