Critical Care Nurses' Practices and Perceptions about Delirium Assessment in Saudi Arabia

Background: Delirium continues to be prevalent. Hence, ICU nurses are facing daunting challenges in providing timely and accurate delirium assessment. Aim: This study aimed to determine the barriers, perceptions, and delirium assessment practices of ICU nurses and explore which of selected participants' characteristics, assessment practices, delirium education, barriers, and perceptions are significantly associated with ICU nurses' frequency of assessing patients with delirium during an average 12 hours shift. Materials and Methods: This study is participated by 136 ICU nurses from two public tertiary hospitals in Riyadh, Saudi Arabia. Descriptive cross-sectional method was used in this survey using self-administered questionnaire. Descriptive statistics and Spearman rho were used in analyzing the data. Results: The study has 75.5% response rate. Most of the participants acknowledged presence of ICU sedation protocol specifying frequency in delirium assessment. Delirium is assessed in varying frequencies during 12 hours shift. ICU nurses considered difficulty in interpreting intubated patients, complexity in using delirium assessment tools as top barriers. They preferred using patient's ability to follow commands in assessing delirium over other delirium assessment tools. Almost 40% never received delirium education. Conclusion: There are gaps in delirium assessment practices, perceptions, and education that can be managed. ICU nurses need educational interventions as well as support mechanisms to enhance their confidence and competencies in assessing delirium. Institution-based delirium assessment protocols needed to be revisited and appraised for its appropriateness and applicability in current times and determine if updating is needed.