Improving delirium detection in intensive care units: Multicomponent education and training program.
J Am Geriatr Soc
; 69(11): 3249-3257, 2021 11.
Article
en En
| MEDLINE
| ID: mdl-34402046
ABSTRACT
BACKGROUND:
Delirium is a common, devastating, and underrecognized syndrome in the intensive care unit (ICU). The study aimed to describe and evaluate a multicomponent education and training program utilizing a "Train-The-Trainer" (TTT) model, to improve delirium detection across a large health system.METHODS:
Fourteen ICUs across nine hospitals participated in a multicomponent delirium program consisting of a 1-day workshop that included (1) patient testimonials, (2) small group discussions, (3) didactics, and (4) role-playing. Additionally, four ICUs received direct observation/training via telehealth (tele-delirium training). The Kirkpatrick model was used for program evaluation in a pre/post-test design.RESULTS:
A 1-day delirium workshop was held at two time points and included 73 ICU nurses. Of the 65 nurses completing the post-workshop satisfaction survey, most (46.2) had >10 years of clinical experience, and no or minimal delirium training (69.2%). All nurses (100%) identified lack of knowledge as a barrier to delirium detection, while time constraints and lack of importance accounted for only 25%. Overall, nurses rated the workshop positively (excellent 66.7%, and very good 23.3%), and likely to change practice (definitely 73.3% and very likely 15.0%). All validated Confusion Assessment Method for the ICU (CAM-ICU) cases demonstrated improvement in number of correct responses. Delirium detection across the health system improved from 9.1% at baseline to 21.2% in ICUs that participated in the workshop and 30.1% in those ICUs that also participated in the tele-delirium training (p = 0.005).CONCLUSION:
A multicomponent delirium education and training program using a TTT model was rated positively, improved CAM-ICU knowledge, and increased delirium detection.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enseñanza
/
Delirio
/
Unidades de Cuidados Intensivos
/
Evaluación en Enfermería
/
Personal de Enfermería en Hospital
Tipo de estudio:
Diagnostic_studies
/
Evaluation_studies
/
Prognostic_studies
/
Qualitative_research
Límite:
Humans
Idioma:
En
Revista:
J Am Geriatr Soc
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos