Abstract
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.
Highlights
Delirium in critically ill children represents acute brain dysfunction and is characterized by a range of alteration in mental states and behaviors
The data collected were analyzed statistically and the results were categorized into 3 main parts which are: Characteristics of studied nurse, nurses learning needs assessment, and barrier of delirium screening among pediatric critical care nurses
The results of the current study demonstrated obvious deficit in studied nurses' knowledge regarding specific parts about pediatric delirium such delirium definition, causes and its management as well as little is known about its incidence, types, hypoactive delirium signs and clinical outcomes of pediatric delirium which reflect on their level of knowledge among the majority of nurses that have poor knowledge level (Table 2, Figure 1)
Summary
Delirium in critically ill children represents acute brain dysfunction and is characterized by a range of alteration in mental states and behaviors. 2013 defines delirium as an etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behavior, emotion, and the sleep-wake schedule, its duration is variable and the degree of severity ranges from mild to very severe [1]. As well as numerous conditions, including sepsis, hypoxia, sedative exposure, and others, contribute to delirium during critical illness. It is unknown whether adverse long-term cognitive outcomes associated with delirium are predicted by specific risk factor-defined subtypes or by all subtypes of delirium [3]
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