Developing Capacity to Care for a Client at Risk for Delirium and for the Acutely Delirious Client

ABSTRACT The purpose of this mixed methods study was: (a) to assess nurses’ knowledge and self-efficacy of caring for clients experiencing delirium and those at risk of developing delirium in a hospital setting prior to and immediately after taking part in a clinical education session, and (b) to explore nurses’ experiences of applying knowledge from the education session to the practice setting. Objectives of the education session included reviewing risks, signs, symptoms, standardized screening tools, and management strategies for clients at risk for or experiencing delirium in a hospital setting. For the quantitative methods portion of the study, participants completed instruments to assess knowledge and self-efficacy prior to and immediately after the education session. Pre- and post-instrument score comparisons were made using t-tests. Overall, nurses were found to have gained knowledge of how to recognize and manage delirium. Nurses’ higher ratings of self-efficacy after participating in a clinical education session suggest that those who believe they can assess for and manage delirious clients might engage in future behaviours to decrease exacerbations or incidences of delirium. In the qualitative phase of the study, interviews were undertaken with seven nurses who had participated in the education program. Interview data was transcribed, and a descriptive content analysis was conducted to develop categories and themes related to nurses’ experience of knowledge translation into practice. The participants’ rich experiences where highlighted in the themes, enhancing emotional intelligence, strengthening clinical judgment to enhance quality of care, and increasing competency for family care. This study demonstrates how continuing education in clinical practice can positively impact nursing knowledge, confidence, and application of knowledge into practice in efforts to decrease the prevalence of delirium. As such, an investment in continuing professional development education for delirium recognition and management is proposed to be a strategy that can positively impact client care. Keywords: nurses, delirium, education, clients, acute care, knowledge, self-efficacy, mixed-method