The Long-Term Impact of an Educational Intervention on Nursing Knowledge of Delirium, Perception of the Intensive Care Delirium Screening Checklist and Delirium Screening Compliance in the ICU: A Master’s Thesis

Abstract

Delirium, a frequent complication in the intensive care unit, has significant and widespread impacts on patients, families, and the healthcare system. Interdisciplinary delirium prevention and mitigation strategies are necessary to effectively manage this syndrome. Routine screening by nurses using a validated tool is effective in identifying those patients at risk for or experiencing delirium. This practice is not consistent internationally and lack of knowledge of both delirium and the screening tools appears to be a contributing factor. The overall aim of this manuscript based thesis, was aimed at assessing the long-term impact of a multi-faceted educational intervention on delirium management. This thesis consists of two papers, the first a comprehensive review and the second a research based paper. The first manuscript is a comprehensive overview of delirium intended for critical care nurses to address the knowledge-practice gap. The second paper is a quantitative study that examined the long-term effects at 18-months of a multi-faceted educational intervention on nurses’ knowledge of delirium and the screening tool, and the frequency of delirium assessment in a single intensive care unit. The findings from the second manuscript demonstrate an initial increase in knowledge that was not retained at the 18-month survey period. Nurses perceived the tool to be useful and over the long-term felt physicians were placing more value on it. They did not, however, feel more knowledgeable or confident using the tool. Delirium screening frequency improved after the educational intervention and was maintained over the long-term. This work reinforced and expanded on the findings of previous studies related to the short-term efficacy of a multi-faceted knowledge translation intervention on nursing knowledge and screening of delirium. It also demonstrated that passive knowledge transfer is ineffective in maintaining these knowledge gains over the long-term. Future research needs to focus on establishing an optimal frequency for reinforcing delirium and screening knowledge within the context of the busy clinical setting of the intensive care unit.