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The Journal of Continuing Education in Nursing, 2017;48(5):239–244
Published Online:https://doi.org/10.3928/00220124-20170418-09Cited by:7

Abstract

Background:

Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently.

Method:

A pretest–posttest design was used to evaluate the success of a multimodal educational strategy (i.e., online learning module coupled with standardized patient simulation experience) on critical care nurses' knowledge and confidence to assess and manage delirium using the CAM-ICU.

Results:

Participants (N = 34) showed a significant increase (p < .001) in confidence in their ability to assess and manage delirium following the multimodal education. No statistical change in knowledge of delirium existed following the education.

Conclusion:

A multimodal educational strategy, which included simulation, significantly added confidence in critical care nurses' performance using the CAM-ICU.

J Contin Nurs Educ. 2017;48(5):239–244.

  • American Association of Critical Care Nurses. (2014). Synergy model: Basic information about the AACN Synergy Model for patient care. Retrieved from https://www.aacn.org/nursing-excellence/aacn-standards/synergy-model

    > Google Scholar
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

    > CrossrefGoogle Scholar
  • Association of Standardized Patient Educators. (2013). Transforming professionals through the power of human interaction. Retrieved from http://aspeducators.org/node/48

    > Google Scholar
  • Balas M.C., Rice M., Chaperon C., Smith H., Disbot M., Fuchs B. (2012). Management of delirium in critically ill older adults. Critical Care Nurse, 32(4), 15–22.10.4037/ccn2012480

    > Crossref MedlineGoogle Scholar
  • Bandura A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.10.1037/0033-295X.84.2.191

    > Crossref MedlineGoogle Scholar
  • Barr J., Fraser G.L., Puntillo K., Ely E.W., Gelinas C., Dasta J.F.American College of Critical Care Medicine. (2013). Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit: Executive summary. American Journal of Health-System Pharmacy, 70, 53–58.

    > Crossref MedlineGoogle Scholar
  • Benson E.P. (2004). Online learning: A means to enhance professional development. Critical Care Nurse, 24, 60–63.

    > Crossref MedlineGoogle Scholar
  • Devlin J.W., Fong J.J., Howard E.P., Skrobik Y., McCoy N., Yasuda C., Marshall J. (2008). Assessment of delirium in the intensive care unit: Nursing practices and perceptions. American Journal of Critical Care, 17, 555–565.

    > Crossref MedlineGoogle Scholar
  • Ely E.W., Inouye S.K., Bernard G.R., Gordon S., Francis J., May L., Dittus R. (2001). Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit. JAMA, 286, 2703–2710.10.1001/jama.286.21.2703

    > Crossref MedlineGoogle Scholar
  • Gaba D.M. (2004). The future vision of simulation in health care. Quality and Safety in Health Care, 13(Suppl.), 2–10.10.1136/qshc.2004.009878

    > Crossref MedlineGoogle Scholar
  • Grundy S.E. (1993). The confidence scale: Development and psychometric characteristics. Nurse Educator, 18, 6–9.10.1097/00006223-199301000-00004

    > Crossref MedlineGoogle Scholar
  • Hardin S.R. (2009). The AACN Synergy Model. In , Peterson S.J., Bredow T.S. (Eds.), Middle range theories: Application to nursing research (2nd ed., pp. 99–114). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

    > Google Scholar
  • Inouye S.K., van Dyck C.H., Alessi C.A., Balkin S., Siegel A.P., Horwitz R.I. (1990). Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941–948.10.7326/0003-4819-113-12-941

    > Crossref MedlineGoogle Scholar
  • Leigh G. (2011). The simulation revolution: What are the implications for nurses in staff development?Journal for Nurses in Staff Development, 27, 54–57.10.1097/NND.0b013e31820eecea

    > Crossref MedlineGoogle Scholar
  • Olson T. (2012). Delirium in the intensive care unit: Role of the critical care nurse in early detection and treatment. Dynamics, 23(4), 32–36.

    > MedlineGoogle Scholar
  • Pauley E., Lishmanov A., Schumann S., Gala G.J., van Diepen S., Katz J.N. (2015). Delirium is a robust predictor of morbidity and mortality among critically ill patients treated in the cardiac intensive care unit. American Heart Journal, 170, 79–86. http://dx.doi.org/10.1016/j.ahj.2015.04.01310.1016/j.ahj.2015.04.013

    > Crossref MedlineGoogle Scholar
  • Rice K.L., Bennett M., Gomez M., Theall K.P., Knight M., Foreman M.D. (2011). Nurses' recognition of delirium in the hospitalized older adult. Clinical Nurse Specialist, 25, 299–311.10.1097/NUR.0b013e318234897b

    > Crossref MedlineGoogle Scholar
  • Scott P., McIlveney F., Mallice M. (2013). Implementation of a validated delirium assessment tool in critically ill adults. Intensive and Critical Care Nursing, 29, 96–102. http://dx.doi.org/10.1016/j.iccn.2012.09.00110.1016/j.iccn.2012.09.001

    > Crossref MedlineGoogle Scholar
  • Svenningsen H. (2015). A shared language regarding sedation and delirium in critically ill patients. Nursing in Critical Care, 20, 204–209.10.1111/nicc.12187

    > Crossref MedlineGoogle Scholar
  • Tate J.A., Happ M.B. (2012). The Confusion Assessment Method for the ICU (CAM-ICU). Retrieved from https://consultgeri.org/try-this/general-assessment/issue-25.pdf

    > Google Scholar
  • Vanderbilt University Medical Center, Center for Health Sciences Research. (2013). CAM-ICU resources in additional language translations. Retrieved from http://www.icudelirium.org/delirium/languages.html

    > Google Scholar
  • Waszynski C., Petrovic K. (2008). Nurses' evaluation of the Confusion Assessment Method: A pilot study. Journal of Gerontological Nursing, 34(4), 49–56.10.3928/00989134-20080401-06

    > LinkGoogle Scholar
  • Zaal I.J., Slooter A.J. (2012). Delirium in critically ill patients: Epidemiology, pathophysiology, diagnosis and management. Drugs, 72, 1457–1471.10.2165/11635520-000000000-00000

    > Crossref MedlineGoogle Scholar

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