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

Abstract

Background: 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.

Aims: 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.

Research design and setting: 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.

Results: 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.

Conclusion: 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.

Keywords: Critical care nurse; Delirium; Delirium screening tools; Intensive care unit; Medical staff; Research.