Comparing the delirium objective structured clinical examination (OSCE) education package to standard education for post-registration nurses: A randomised controlled trial

Background: A recent pilot study demonstrated that an interactive delirium educational intervention, The Delirium OSCE Education Package, had a positive impact on self -perceptions of confidence and competence in the use of delirium assessment tools and delirium knowledge; delirium knowledge scores; clinical practice; and planned practice change for participants. However, it is not known if The Delirium OSCE Education Package is superior to standard methods of professional development education. Objective: To determine if The Delirium OSCE Education Package is superior to standard methods of professional development education on observations of delirium care in practice scores for post -registration nurses. Design: Clustered randomised, controlled, and observer -blinded, multisite superiority trial with two parallel groups at each site. Settings: Three private hospitals across New South Wales, Australia. Participants: Registered nurses (RNs) ( n = 153) or enrolled nurses (ENs) ( n = 37) working in the eligible inpatient medical or surgical wards at each site. Methods: Within each hospital site wards were clusters, with wards rather than individuals being randomised for The Delirium OSCE Education Package or standard professional development education at a ratio of 1:1. The primary outcome was observations of delirium care in practice, 6 -weeks post (T1) allocated intervention. Secondary outcomes were self -perceived confidence and competence (self -efficacy) in delirium assessment tools and delirium knowledge; and delirium knowledge scores. Results: A total of 51.3 % ( n = 20) in the intervention group obtained a satisfactory observation of delirium care in practice score, compared to 34.9 % ( n = 15) in the control group ( p = 0.134, chi 2 ). The odds of a satisfactory observation of delirium care in practice score for the intervention group was 10.1 times higher than the control ( p = 0.009). The mean MCQ score and perceptions of confidence and competence in the intervention and control group increased from baseline to six -weeks post -intervention, however, there was no significant difference between the groups. Conclusion: The Delirium OSCE Education Package provides the foundation for facilitating change in delirium care. It is recommended that The Delirium OSCE Education Package is implemented as part of a multicomponent strategy involving a validation delirium screening and assessment tool, hospital -specific policy, interprofessional education, and delirium champions. Future studies are needed to evaluate the sustainability of the intervention and if there is a positive impact on patient -level outcomes.