IMPACT OF A DELIRIUM SCREENING TOOL AND MULTIFACETED EDUCATION ON NURSES' KNOWLEDGE OF DELIRIUM AND ABILITY TO EVALUATE IT CORRECTLY

Background The impact of using a validated delirium screening tool and different levels of education on surgical-trauma intensive care unit (STICU) nurses' knowledge about delirium is unclear. Objectives To measure the impact of using the Intensive Care Delirium Screening Checklist (ICDSC), with or without a multifaceted education program, on STICU nurses' knowledge and perceptions of delirium and their ability to evaluate it correctly. Methods The knowledge and perceptions of subject nurses about delirium, and agreement between the independent assessments of delirium by the subject nurse and by a validated judge (who always used the ICDSC), were compared across 3 phases. Phase 1: No delirium screening tool and no education. Phase 2: ICDSC and minimal education (ie, ICDSC validation study only). Phase 3: ICDSC and multifaceted education (ie, pharmacist-led didactic lecture, Web-based module, and nurse-led bedside training). Results Nurses' knowledge (mean [SD] score out of 10 points) was similar (P=.08) in phase 1 (6.1 [1.4]) and phase 2 (6.5 [1.4]) but was greater (P=.001) in phase 3 (8.2 [1.4]). Agreement between nurses and the validated judge in the assessment of delirium increased from phase 1 (kappa = 0.40) to phase 2 (kappa = 0.62) to phase 3 (kappa = 0.74). Nurses perceived use of the ICDSC as improving their ability to recognize delirium. Conclusions Use of a multifaceted education program improves both nurses' knowledge about delirium and their perceptions about its recognition. Implementation of the ICDSC improves the ability of STICU nurses to evaluate delirium correctly. (Am J Crit Care. 2012;21:e1-e11)