RESUMO
BACKGROUND: Completion of a delirium detection tool allows rapid management, which alleviates complications. However, these tools are often underused. AIMS: To assess the effect of a knowledge transfer (KT) intervention on the completion of a delirium detection tool by nurses working with cardiac surgery patients. Secondary aims included describing completion rates per work shift, and patient characteristics associated with higher rates. METHODS: In a pre-post study, the intervention included a survey and focus groups to identify barriers to use of a delirium detection tool (Intensive Care Delirium Screening Checklist [ICDSC]). Nurses' suggestions for a KT activity and its implementation were also included. Using chi-square analysis and medical charts from 242 patients, we compared the pre- and postintervention rates of completion of the ICDSC. RESULTS: The majority of nurses who completed the survey (n = 30) felt they had the knowledge, skills, and intention to complete the ICDSC. During the focus groups (n = 4), a need for information on delirium symptoms and its management was raised as a barrier. This barrier was addressed with the selected KT activity (clinical capsule and aide-memoire handed out to nurses [n = 24]). Across all work shifts, the completion rate was similar pre- and postintervention. Overall, the completion rate was lower during the day shift than the night and evening shifts. A higher rate was associated with the first three postoperative days, and longer hospital and intensive care unit stays. LINKING EVIDENCE TO ACTION: A tailored intervention based on preidentified barriers and facilitators, using the Determinants of Implementation Behavior Questionnaire, and in collaboration with participants, has the potential to promote evidence-based practice.
Assuntos
Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Lista de Checagem/normas , Delírio/diagnóstico , Programas de Rastreamento/métodos , Adulto , Canadá , Procedimentos Cirúrgicos Cardiovasculares/enfermagem , Feminino , Grupos Focais , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Programas de Rastreamento/instrumentação , Inquéritos e Questionários , Centros de Atenção Terciária/organização & administraçãoRESUMO
As has been known for a long time, the measurement of the pulse enables the patient's haemodynamic state to be assessed. Pulse, rate, rhythm and amplitude are indicators that enable monitoring of health status in different situations. Therefore, the nurse, in her daily practice, can and must use this measurement in preference to that provided by devices whose relevance is limited.