Nurses' assessment of subsyndromal delirium and barriers to assessment: A cross-sectional survey in the intensive care unit

AimsThe aims of the study are to investigate the current status of nurses' assessment of subsyndromal delirium (SSD) in the intensive care unit (ICU) and explore possible barriers to assessment. BackgroundSSD is a dynamic, recognizable disorder commonly seen in the ICU that can lead to poor patient outcomes. Timely recognition and management can prevent its progression. MethodsA cross-sectional survey design was used to collect data from ICU registered nurses in southwest China. The online survey containing an analysis of the current status of SSD assessment and barriers was completed by 237 nurses. ResultsA total of 51.5% of nurses chose to assess SSD using an assessment tool, the most commonly used being the Confusion Assessment Method for the Intensive Care Unit; the frequency of assessment was mostly once a day (66, 41.0%) and often at shift change (178, 87.3%). There were statistically significant differences in the barrier factor scores by assessment frequency, assessment method, status of training in SSD, ability of SSD-related knowledge to meet clinical needs and willingness to receive SSD training. ConclusionOur study confirms that the current state of assessment of SSD in the ICU is unsatisfactory, with nurses' lack of assessment knowledge and skills, poor organization and management, and the complexity of patients' conditions being barriers. Implications for nursing managementNursing managers should systematically conduct training programmes on effective SSD assessment knowledge and skills, incorporate SSD assessment into the daily workflow, have standardized assessment tools, develop standardized processes and assign dedicated staff to monitor, audit and provide feedback on SSD assessments.