Perceptions, Attitudes, and Behaviors Towards Delirium Among ICU Nurses at a Small Community Hospital in Southern Arizona

Most health care providers lack the education or clinical training to adequately recognize delirium. and are distressed when caring for patients with delirium (Akechi et al., 2010; Brajtman, Higuchi, & McPherson, 2006; Griffiths, Knight, Harwood, & Gladman, 2014; McCrow, Sullivan, & Beattie, 2014). Early recognition of delirium can improve patient safety and decrease the use of hospital resources (National Institute for Health and Care Excellence, 2014). Although delirium knowledge and recognition are increased after implementation of education and the use of screening tools, more could be done to improve patient outcomes and increase sustainability of knowledge learned (Yanamadala et al., 2013; Soja et al., 2008; van den Boogaard et al., 2009; Pun et al., 2005). The purpose of this DNP project was to explore the perceptions, attitudes and behaviors of ICU nurses in a community hospital when caring for patients with delirium. Findings indicated that most nurses felt delirium is an underdiagnosed problem. Almost all agreed or strongly agreed that assessing ICU patients for delirium is a worthwhile intervention. Interestingly, 38.5% disagreed and 30.7% were neutral that delirium is largely preventative. Despite 69.2% of the participants agreeing that they felt heard by the provider when they suspect the patient is delirious, 76.9% are neutral that they are satisfied with the applied treatment. Despite agreeing that delirium is underdiagnosed, there is lack of knowledge regarding prevention and treatment of delirium. In this ICU, it would be beneficial to tailor the education prior to implementing any delirium screening tools. Results show that education should include: the types of delirium, delirium prevention strategies, RASS scales, importance of daily sedation vacations, and treatment. Education should be provided to both the nurses and the providers. In addition to this, "buy in" should be obtained from the providers to ensure that they will use data gathered from screening tools. Prior to implementing any screening tool, examples of screening tools should be provided to the staff, as well as a bedside demonstration to show ease of use. An additional study should be done to assess the sustainability after tailoring education based on perceptions, attitudes, and behaviors