Knowledge Of Delirium Research Articles

Review of Nurses’ Knowledge of Delirium, Dementia and Depressions (3Ds): Systematic Literature Review

This paper aims at reviewing literature on nurses’ knowledge of delirium, dementia and depression (3Ds) which are rapidly increasing worldwide as the population ages, and to identify interventions that have shown effectiveness in improving nurses’ knowledge level of these diseases. Nurses’ knowledge of delirium, dementia and depression is essential to providing quality patient care. To access the literature, online databases including Medline (OVID), CINAHL (EBSCO), Nursing and Allied Health Source (ProQuest), and Health and Medicine (ProQuest), in addition to Google scholar search engine, were searched using key words “delirium”, “dementia”, “depression”, “nurse*”, “knowledge” and their alternative words. Overall, 20 articles were found to meet the criteria for inclusion in the review. The study found that nurses’ knowledge of the 3Ds was generally low, and they were not particularly able to differentiate between the three diseases. It is important that health care systems are adequately resourced to meet this growing challenge. Nurses should receive appropriate training about the 3Ds, and their knowledge be reinforced through continuing education.

A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer Program.

Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors. FC Delirium TTT sessions were implemented in a large four-hospital network and consisted of presession online work and a 3-hour in-session component. The 156 TTT interprofessional participants who attended the sessions (ie, trainers) were expected to then deliver delirium training to their patient care units. Delirium care self-efficacy and knowledge test scores were measured before, after, and 6 months after the training session. Clinician delirium assessment rates were measured by chart audits before and 3 months after trainer's implementation of delirium training sessions. Delirium knowledge test scores (7.8 ± 1.6 versus 9.7 ± 1.2, P < .001) and delirium care self-efficacy were significantly higher immediately after the TTT session compared with those of presession and these differences remained significant at 6-month after the TTT session. Trainer sessions significantly improved clinician delirium assessment rates from 53% for pretraining to 66% for posttraining. Our data suggest that a TTT FC delirium training approach can improve participants' perceived delirium care skills and confidence, and delirium knowledge up to 6 months after the session. This approach provides a model for implementing hospitalwide delirium education that can change delirium assessment behavior while minimizing time and personnel requirements.

Delirium superimposed on dementia: a survey of delirium specialists shows a lack of consensus in clinical practice and research studies.

Despite advances in delirium knowledge and the publication of best practice guidelines, uncertainties exist regarding assessment of Delirium Superimposed on Dementia (DSD). An international survey of delirium specialists was undertaken to evaluate current practice. Invitations to participate in an online survey were distributed by email among members of four international delirium associations with additional publication on their websites. The survey covered the assessment and diagnosis of DSD in clinical practice and research studies. Questions were structured around current practice and attitudes. The 205 responders were mostly confident that they could detect DSD with 60% rating their confidence at 7 or above on a likert scale of 0 (none) to 10 (excellent). Seventy-six percent felt that Dementia with Lewy Bodies (DLB) was the most challenging dementia subtype in which to diagnose DSD. Several scales were used to assess for the presence of DSD including the Confusion Assessment Method (CAM) (54%), DSM-5 criteria (25%) and CAM-ICU (15%). Responders stated that attention (71%), fluctuation in cognitive status (65%), and arousability (41%) were the most clinically useful features to assess when diagnosing DSD. Motor fluctuations were also deemed important but 61% had no specific test to monitor these. The largest survey of DSD practice to date demonstrates that despite good levels of confidence in recognizing DSD, there exists a lack of consensus concerning assessment and diagnosis globally. These findings suggest the need for the development of more research leading to precise diagnostic criteria and comprehensive guidelines regarding the assessment and diagnosis of DSD.

Is delirium being detected in emergency?

To report on the use of Delirium Care Pathways to screen for and recognise delirium by Aged Care Services in Emergency Teams (ASETs) at five metropolitan hospitals in New South Wales, Australia. Knowledge of delirium and the use of Delirium Care Pathways are vital to ensure that older people presenting with delirium receive best practice care. An audit of 205 randomly selected medical records of clients over 65 years presenting to an ASET was conducted. Delirium was recorded in the medical records notes of four clients (2%). However, the auditors identified another 27 clients with symptoms of delirium. Delirium is still frequently undiagnosed and misdiagnosed in older people presenting to emergency departments. This indicates a need for further education and professional development for and by health-care practitioners. Only with greater awareness of delirium will the care and health outcomes of older adults presenting with delirium in acute care settings improve.

Strategies to improve nurse knowledge of delirium: a call to the adult-gerontology clinical nurse specialist.

The purpose of this article is to discuss the role of the adult-gerontology clinical nurse specialist in addressing the problem of delirium in hospitalized older adults through strategies to improve nurse knowledge. Delirium is a significant issue in hospitalized older adults. This acute confusional state can adversely impact older adults in various ways. Delirium has been implicated in (1) poor physical, cognitive, and psychological outcomes, (2) prolonged hospitalizations, (3) increased costs of care, (4) need for continued postacute care, and (5) patient and provider stress. To prevent delirium, nurses must possess the knowledge to identify risk factors and institute preventive strategies. Once a change in mental status occurs, it is critical that nurses recognize delirium and the steps necessary to provide safe, effective care. Nurses are the major providers of bedside care; however, multiple studies have identified a lack of nurse knowledge regarding delirium. The adult-gerontology clinical nurse specialist can be instrumental in fostering knowledge on this important issue. Multiple interventions can be conducted by the adult-gerontology clinical nurse specialist with acute care nurses to increase delirium knowledge. A review of the literature revealed strategies that might be used in the hospital setting. Before educational endeavors, it is crucial to assess baseline nurse knowledge of delirium. Educational strategies can then include use of standardized delirium assessment tools, implementation of the Geriatric Resource Nurse model, fostering geriatric case studies and simulations, conducting geriatric grand rounds, and development of structured delirium educational programs. Exploring the patient experience, post delirium, can provide an invaluable, first-hand account of the acute confusional state. This information can impact nurse knowledge as well as patient safety and well-being. Geriatric certification and professional organizational involvement can be encouraged. Numerous online geriatric resources can be shared with nurses to enhance knowledge of delirium. Improved nurse knowledge will assist in preventing/decreasing incidents of delirium and thwart the negative outcomes associated with delirium occurrence in hospitalized older adults. Nurse knowledge can be measured and patient care assessed to determine the effectiveness of the proposed educational strategies. The goal of the identified adult-gerontology clinical nurse specialist-led educational initiatives is to improve knowledge of delirium, which will assist nurses in providing evidence-based, safe, appropriate care to all hospitalized older adults.

Psychometric Properties of the Family Caregiver Delirium Knowledge Questionnaire.

A valid, reliable measure of family caregivers' knowledge about delirium was not located in the literature; such an instrument is essential to assess learning needs and outcomes of education provided. The purpose of the current study was to (a) develop a family Caregiver Delirium Knowledge Questionnaire (CDKQ) based on the Symptom Interpretation Model; and (b) establish validity and reliability of the measure. The 19-item CDKQ was developed and administered to 164 family caregivers for community-dwelling older adults. Descriptive statistics were examined for all variables. Psychometric testing included confirmatory factor analysis, item-to-total correlations, and internal consistency reliability. A three-factor model provided the best fit for the data. The findings support initial validity and reliability of the CDKQ with family caregivers. Although the CDKQ was developed for use with family caregivers, it has potential for use with other caregivers, such as home health aides.

The effect of an e-learning course on nursing staff's knowledge of delirium: a before-and-after study.

BackgroundDelirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which might be due to a lack of knowledge of delirium diagnosis and treatment. The objective of the study was to test the effectiveness of an e-learning course on nurses’ delirium knowledge, describe nursing staff’s baseline knowledge about delirium, and describe demographic factors associated with baseline delirium knowledge and the effectiveness of the e-learning course.MethodsA before-and-after study design, using an e-learning course on delirium. The course was introduced to all nursing staff of internal medicine and surgical wards of 17 Dutch hospitals.Results1,196 invitations for the e-learning course were sent to nursing staff, which included nurses, nursing students and healthcare assistants. Test scores on the final knowledge test (mean 87.4, 95% CI 86.7 to 88.2) were significantly higher than those on baseline (mean 79.3, 95% CI 78.5 to 80.1). At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk. The mean score for this category was 74.3 (95% CI 73.1 to 75.5).ConclusionsThe e-learning course significantly improved nursing staff's knowledge of delirium in all subgroups of participants and for all question categories. Contrary to other studies, the baseline knowledge assessment showed that, overall, nursing staff was relatively knowledgeable regarding delirium.Trial registrationThe Netherlands National Trial Register (NTR). Trial number: NTR 2885, 19 April 2011.

We can Do it: Nursing Educational Intervention to Increase Delirium Documentation

Background/Objectives: Delirium is a widely recognized complication during hospitalization, but poorly documented. We examined the effectiveness of a geriatrician-guided delirium training intervention to increase nurses’ delirium documentation, knowledge, and self- confidence. Design: Prospective cohort study Setting: Orthopedic surgical inpatient unit Participants: Twenty-six nursing staff Intervention: Nurses participated in a geriatrician-guided delirium training intervention. Each nurse received two 45-minute didactic sessions on delirium causes, screening, and prevention using the Confusion Assessment Method (CAM). Measurements: Nursing delirium documentation pre- and post-educational intervention was determined during the months of March and June 2013. Nurses also completed a pre- and 3-month post-interventional survey to assess confidence and knowledge of delirium detection. Results: Nursing mean age was 46 years, with 17 years of experience. Patients with CAM documentation increased significantly post-intervention from 13 to 91% (p<0.001). On average, rate of nursing CAM documentation per shift increased from 5.5 to 70.8%, (p<0.001). Post-interventional nursing knowledge scores significantly improved from 44 to 73% correct (p<0.001). As compared to pre-intervention, nurses scored significantly higher on number of delirium risk factors from 32 to 71% (p<0.001), medications to avoid in the elderly from 20 to 70% (p<0.001), and correct management strategies for patients with delirium from 52 to 84% (p<0.001). Nurses’ confidence in detecting delirium increased significantly post-intervention from 7.8 to 8.6 points out of a 10-point scale (p=0.021). Conclusion: Nursing knowledge and documentation of delirium using the CAM, as well as nursing confidence in identifying delirium all significantly increased after formal geriatrician-guided educational intervention.

Implementation of an Intensive Care Unit Delirium Protocol: An Interdisciplinary Quality Improvement Project.

Delirium is a commonly observed problem for adult patients in the intensive care unit (ICU) that is associated with increased mortality, increased hospital length of stay, and long-term disability of ICU survivors. This makes prevention and prompt treatment of delirium imperative goals for critical-care providers. Bedside critical-care nurses are uniquely poised to champion efforts to prevent, detect, and treat delirium but oftentimes are not aware of the most recent evidence-based guidelines or the potential long-term implications for the ICU survivor. Nurses have reported higher levels of confidence in detecting delirium, increased knowledge of delirium, and enhancement of patient care skills after receiving formal didactic educational training. The objectives of this quality improvement project were to develop, implement, and evaluate a nursing education program for critical-care nurses that presented a protocol for the prevention and management of delirium in adult ICU patient populations, as well as improve nurses' familiarity, comfort, and compliance with using a standardized evaluation method for delirium and intervention care bundle. A didactic training program for bedside critical-care nurses was developed and implemented. Upon completion of the educational sessions, a daily bedside delirium screening and care bundle protocol were implemented for all patients in ICUs throughout the facility. Bedside critical-care nurses were invited to participate in the formal teaching sessions. This included nursing staff from each of the 3 ICUs in this facility, as well as supplemental "float pool" staff. Pre-educational and posteducational nursing attitudes and self-perceived confidence levels regarding delirium care were measured using a 5-point Likert scale. Pre-educational and posteducational nursing knowledge was measured using raw scores obtained from a 15-item multiple choice test. Following the implementation of the delirium screening and care bundle protocol, nursing staff compliance with screening and care bundle items was measured, as well as overall incidence of positive delirium screenings among all screenings completed. A sample of 49 nurses participated in the formal educational teaching sessions. All 5 nursing attitude and perceived confidence statements measured before and after the educational sessions showed a significant increase in positive perceptions overall (P < .0001). Overall mean posteducation knowledge test raw scores showed a significant improvement from pre-educational scores (70% ± 12.8% vs 95% ± 6.9%; P < .0001). Once-daily ICU delirium screenings and care bundle interventions were initiated for all ICU patients; overall compliance during the measurement period was 56.3% (598 of 1061 possible delirium screenings and protocols completed). Of all daily patient screenings performed, 20.4% resulted positive for ICU delirium. All patients who received the care bundle interventions received the interventions uniformly, regardless of clinical delirium status. This quality improvement project demonstrates that a formal didactic training program for ICU nurses can result in increased awareness and knowledge of ICU delirium and adequately prepare them for how to properly screen and treat patients. Although overall compliance with implementing daily ICU delirium screenings and care bundle interventions was relatively low, those patients who did receive screening and interventions demonstrated that the incidence of positive delirium screenings at this facility is low compared with reported figures. In addition, patients who did receive the appropriate care bundle interventions did so in a uniform manner, regardless of the presence or absence of clinical delirium.

Delirium knowledge and assessment by ICU practitioners in South Africa: results of a national survey

Delirium recognition in critically ill patients is considered to be important taking into account the poor outcomes associated with its occurrence. The purpose of this study was to evaluate knowledge pertaining to delirium as well as the implementation of screening practices. This study constituted a component of a survey that explored current sedation-related practices in South African ICUs.

A multifaceted intervention package to improve the diagnosis and management of delirium.

ABSTRACT Background: Delirium is a major cause of morbidity and mortality amongst hospital patients. Previous studies have shown that it is often poorly recognized and managed. We wanted to assess the impact of a multifaceted intervention on delirium management. Methods: A pre/post-intervention design was used. The local hospital delirium guideline was adapted into A7 sized cards and A3/A2 posters. Cards were distributed to junior doctors and teaching sessions were held. Computer screen savers were displayed and delirium promotion days held. The pre/post-intervention data were used to audit the following: delirium knowledge through questionnaires, documented use of the confusion assessment method (CAM) and identification and management of eight common precipitating factors. Re-audit was four months post baseline with interventions within this period. χ2 tests were used for statistical analysis. Results: A convenience sample of randomly selected doctors in postgraduate training posts completed 100 questionnaires and 25 clinical notes were selected via retrospective identification of delirium. Results from questionnaires demonstrated significant improvements in: recognizing CAM as the diagnostic tool for delirium (24% vs. 71%, p < 0.01); identifying haloperidol as first line in pharmacological management (55% vs. 98%, p <0.01) and its correct dose (40% vs. 67%, p <0.01). In clinical practice, there was significant improvement in documentation of CAM for inpatient delirium assessments (0% vs. 77%, p <0.01). Trainees found the delirium card "very helpful" (82%) and carried it with them at all times (70%). Conclusion: This multifaceted intervention increased CAM use in delirium recognition and improved the knowledge of pharmacological management. The delirium card was highly popular.

ICU delirium: A survey into nursing and medical staff knowledge of current practices and perceived barriers towards ICU delirium in the intensive care unit

Delirium is an independent predictor of mortality and morbidity in the intensive care unit and is associated with a prolonged hospital and intensive care unit stay. National guidelines suggest that intensive care unit delirium is screened for daily using the confusion assessment method for the intensive care unit validated screening tool. Research suggests that there is a lack of knowledge on intensive care unit delirium, its screening tools and that it is inadequately screened for. The aim of the study is to assess nursing and medical staff knowledge, understanding and management of intensive care unit delirium and assess the perceived barriers associated with intensive care unit delirium screening using a validated screening tool. A survey design was used and a questionnaire designed to collect the data. The sample consisted of 149 nursing and medical staff working in three district intensive care units within the United Kingdom. The data yielded reveals that 44% (n = 33) of the respondents were not educated on ICU delirium. Furthermore the confusion assessment method for the intensive care unit was only being used in one out of the three sites surveyed and this was found to be at best sporadic, this fails to adhere to current delirium guidelines (NICE, 2010). Those using a non structured way of detecting delirium observed for hallucinations and agitation. Common associated barriers quoted in the literature such as time restraints did not appear to be an issue in this study. This study has shown that despite national guidelines screening with a validated delirium screening tool is not being performed in two of the intensive care unit surveyed and one site employs the confusion assessment method for the intensive care however screening is sporadic. This study contributes to the evidence base suggesting that intensive care unit delirium is under recognised and screened for despite current guidelines.

Family Caregivers' Knowledge of Delirium and Preferred Modalities for Receipt of Information.

Delirium is a life-threatening, frequently reversible condition that is often a sign of an underlying health problem. In-hospital mortality alone for older adults with delirium ranges from 25% to 33%. Early recognition of delirium is critical because prolonged duration poses a greater risk of poor functional outcomes for older adults. Family caregivers, who are familiar with the older adult's usual behaviors, are most likely to recognize delirium symptoms but might dismiss them as due to aging. It is important to learn what family caregivers know about delirium to ascertain their need for education. The aims of this study were to describe family caregivers' knowledge of delirium and preferred modalities for receipt of information about delirium. A cross-sectional design was used for this study and a survey distributed to family caregivers for older adults. Analysis of 134 usable surveys indicated that family caregivers need and want information about delirium. The preferred modalities for receipt of information included Internet, in-person classes, and newsletters.

Can an e-learning course improve nursing care for older people at risk of delirium: a stepped wedge cluster randomised trial.

BackgroundDelirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes. Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care. The objective of the study was to determine whether e-learning can be an effective means of improving implementation of a quality improvement project in delirium care. This project aims primarily at improving the early recognition of older patients who are at risk of delirium.MethodsIn a stepped wedge cluster randomised trial an e-learning course on delirium was introduced, aimed at nursing staff. The trial was conducted on general medical and surgical wards from 18 Dutch hospitals. The primary outcome measure was the delirium risk screening conducted by nursing staff, measured through monthly patient record reviews. Patient records from patients aged 70 and over admitted onto wards participating in the study were used for data collection. Data was also collected on the level of delirium knowledge of these wards’ nursing staff.ResultsRecords from 1,862 older patients were included during the control phase and from 1,411 patients during the intervention phase. The e-learning course on delirium had a significant positive effect on the risk screening of older patients by nursing staff (OR 1.8, p-value <0.01), as well as on other aspects of delirium care. The number of patients diagnosed with delirium was reduced from 11.2% in the control phase to 8.7% in the intervention phase (p = 0.04). The e-learning course also showed a significant positive effect on nurses’ knowledge of delirium.ConclusionsNurses who undertook a delirium e-learning course showed a greater adherence to the quality improvement project in delirium care. This improved the recognition of patients at risk and demonstrated that e-learning can be a valuable instrument for hospitals when implementing improvements in delirium care.Trial registrationThe Netherlands National Trial Register (NTR). Trial number: NTR2885.

Delirium-biomarkers and genetic variance.

Advancement in quality of health care has resulted in improved patient outcomes; however, knowledge of delirium as well as methods of treatment and its prevention are not well known. The prevalence of delirium in postoperative patients is associated with an increase in mortality, impaired recovery, and increased hospital costs (Chu et al., 2011). Complex syndromes, like delirium, are usually not associated with a single independent cause but instead with a number of different sources (van Munster et al., 2011). Delirium is defined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) as a disturbance in attention and awareness according to several criteria (American Psychiatric Association, 2013). Biomarkers are biochemical or molecular traces related to the presence or severity of a disease (Chu et al., 2011). Biomarkers present before the onset of the disease can be used as a risk marker, the rise and fall of biomarkers during illness can be tracked as a disease marker, and remaining biomarkers can be seen as an end product of a disease (Chu et al., 2011). The aim of this paper is to identify biomarkers that may have a diagnostic and prognostic role in delirium.

Identifying the Barriers and Enablers to Palliative Care Nurses' Recognition and Assessment of Delirium Symptoms: A Qualitative Study

ContextDelirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. ObjectivesThe aim of the study was to identify nurses' perceptions of the barriers and enablers to recognizing and assessing delirium symptoms in palliative care inpatient settings. MethodsA series of semistructured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants' recall of delirium and identification of the perceived factors (barriers and enablers) that impacted on their delirium recognition and assessment capabilities. Thematic content analysis was used to analyze the qualitative data. ResultsThirty participants from nine palliative care services provided insights into the barriers and enablers of delirium recognition and assessment in the inpatient setting that were categorized as patient and family, health professional, and system level factors. Analysis revealed five themes, each reflecting both identified barriers and current and/or potential enablers: 1) value in listening to patients and engaging families, 2) assessment is integrated with care delivery, 3) respecting and integrating nurses' observations, 4) addressing nurses' delirium knowledge needs, and 5) integrating delirium recognition and assessment processes. ConclusionSupporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels.

Palliative care nurses’ recognition and assessment of patients with delirium symptoms: A qualitative study using critical incident technique

BackgroundDelirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses’ integral patient care role, little is known about palliative care nurses’ capacity to recognise, assess and respond to patients’ delirium symptoms. ObjectiveTo explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. Settings and participants30 nurses from nine Australian specialist palliative care inpatient services. Design and methodsCritical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt their recollection and recounting of a similar clinical incident. Clearly recalled and described incidents were analysed using thematic content analysis. Findings20 of 30 participants recalled and described 28 relevant delirium incidents. Two themes and six sub-themes provide a general description of participants’ experiences, views and practice in delirium recognition and assessment. Participants experience distress related to caring for patients with delirium and express compassion and empathy for delirious patients. Enhancing their delirium knowledge, strengthening collaborative multidisciplinary team relationships and better communication are important supports. Some participants, usually those in advance practice roles, describe more comprehensive assessment capabilities that incorporate clinical expertise with whole person awareness, yet systematic and structured delirium screening and assessment processes and application of the delirium diagnosis criteria are largely missing. Use of ambiguous terminology to describe delirium symptoms contributes to ineffective practice. ConclusionsThe findings of this study expands our understanding of how palliative care nurses’ capacity to recognise and assess patients’ delirium symptoms in the inpatient setting could be strengthened.

Palliative Care-Led Educational Session to Improve Delirium Knowledge: Recognition, Prevalence, Risk Factors, and Complications in Medical and Surgical ICUs in an Academic Medical Institution (S727)

Palliative Care-Led Educational Session to Improve Delirium Knowledge: Recognition, Prevalence, Risk Factors, and Complications in Medical and Surgical ICUs in an Academic Medical Institution (S727)

The Effects of Delirium Care Training Program for Nurses in Hospital Nursing Units

Purpose: The purpose of this study was to examine the effects of delirium care training program on the nurses’ knowledge of delirium, self-confidence and performance levels in caring patients with delirium. Methods: The study was used a quasi-experimental design. The participants were 131 nurses in general nursing units in B and J hospitals. Sixty four nurses in B hospital were allocated into the experimental group and 67 nurses from J hospital into the control group. The delirium care training program was composed of lecture and clinical practice. Clinical practice of delirium care was applied everyday for 4 consecutive weeks starting from the admission day of the older adults(≥70 years old), using ‘short CAM' and ‘nursing checklist for delirium prevention’. Results: The knowledge of delirium, self-confidence in caring patients, and performance levels of nursing care were significantly increased in the experimental group compared to the control group. Conclusion: The findings of this study provided the evidence for the potential utility of the delirium care training program and underscored the needs of broader application of the training program of delirium care for nurses in general nursing units.

Nurse/family caregiver intervention for delirium increases delirium knowledge and improves attitudes toward partnership

Delirium is highly prevalent, especially in hospitalized older adults and is a costly, significant predictor of poor outcomes, including mortality and institutionalization. Partnership between family caregivers and staff nurses could be a cost-neutral preventive strategy. The Nurse/Family Caregiver Partnership for Delirium Prevention (NFCPM) is an innovative educational program that concurrently teaches family caregivers and nurses about delirium and partnering in prevention. The purpose of this feasibility study was to examine the effect of the NFCPM on knowledge of delirium, attitudes toward partnership, and satisfaction with the NFCPM. A quasi-experimental pretest-posttest design was used to enroll 28 patients, 28 family caregivers, and 28 staff nurses. The intervention group significantly improved knowledge of delirium and attitudes toward partnership. Key to satisfaction were participation in decision making, communication, and respect. The NFCPM appears feasible for clinical practice and provides an innovative strategy for family and nurses to improve hospital outcomes for older adults.