Spanish Translation and Cultural Adaptation of the Intensive Care Unit Delirium Playbook

Background: A lack of high -quality provider education hinders the delivery of standard -of -care delirium detection and prevention practices in the intensive care unit (ICU). To fill this gap, we developed and validated an e -learning ICU Delirium Playbook consisting of eight videos and a 44 -question knowledge assessment quiz. Given the increasing Spanish-speaking population worldwide, we translated and crossculturally adapted the playbook from English into Spanish. Objective: To translate and culturally adapt the ICU Delirium Playbook into Spanish, the second most common native language worldwide. Methods: The translation and cross-cultural adaptation process included double forward and back translations and harmonization by a 14 -person interdisciplinary team of ICU nurses and physicians, delirium experts, methodologists, medical interpreters, and bilingual professionals representing many Spanish-speaking global regions. After a preeducation quiz, a nurse focus group completed the playbook videos and posteducation quiz, followed by a semistructured interview. Results: The ICU Delirium Playbook: Spanish Version maintained conceptual equivalence to the English version. Focus group participants posted mean (standard deviation) pre- and post-playbook scores of 63 % (10 % ) and 78 % (12 % ), with a 15 % (11 % ) pre - post improvement ( P = 0.01). Participants reported improved perceived competency in performing the Confusion Assessment Method for the ICU and provided positive feedback regarding the playbook. Conclusion: After translation and cultural adaptation, the ICU Delirium Playbook: Spanish Version yielded significant knowledge assessment improvements and positive feedback. The Spanish playbook is now available for public dissemination.