Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study

Tianxiang Jiang; Tao-Hsin Tung; Yuecong Wang; Xu Tong Zheng; Limin Jia; Wenyuan Zhang

doi:10.1016/j.aucc.2023.12.004

Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study

Aust Crit Care. 2024 Feb 6:S1036-7314(24)00002-X. doi: 10.1016/j.aucc.2023.12.004. Online ahead of print.

Authors

Tianxiang Jiang¹, Tao-Hsin Tung², Yuecong Wang³, Xu Tong Zheng⁴, Limin Jia⁵, Wenyuan Zhang⁶

Affiliations

¹ Intensive Care Unit, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China. Electronic address: jia313315@163.com.
² Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China.
³ Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou, Zhejiang Province, China.
⁴ Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, China.
⁵ Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China.
⁶ Intensive Care Unit, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China.

PMID: 38326188
DOI: 10.1016/j.aucc.2023.12.004

Abstract

Background: Intensive care nurses experience many difficulties in caring for patients with delirium. Thus, it is valuable to conduct in-depth research on the factors that influence the difficulties faced by intensive care nurses in caring for those with delirium as doing so can result in tangible improvements in patient outcomes.

Objectives: The objective of this study was to explore the difficulties faced by intensive care nurses in caring for patients with delirium in light of the demographic, clinical, and professional and management characteristics of nurses.

Methods: A cross-sectional study involving 360 intensive care nurses from eight general hospitals in Taizhou, Zhejiang Province, China. The participants completed questionnaires assessing the level of difficulty they faced in caring for patients with delirium and their level of delirium-related knowledge.

Results: The highest overall mean scores on the difficulty scale subscales were observed for ensuring safety (2.92 ± 0.30), dealing with stress and distress (2.80 ± 0.37), and lack of resources (2.85 ± 0.41). The main factors influencing nurses' difficulty in caring for these patients were title, status as a critical care specialist nurse, training regarding delirium, a standardised delirium management process, the knowledge level regarding delirium, the total number of years working in the intensive care unit, and work communication ability. Likewise, most of these characteristics made it difficult for the nurses to use delirium screening tools.

Conclusions: This study provides insights into factors influencing the difficulties faced by intensive care nurses in caring for patients with delirium and in using delirium screening tools. Our findings suggested that nursing managers could develop targeted improvement strategies and provide more resources to support nurses, thereby improving the quality of delirium care and patient outcomes by using the results from this study. These findings can also provide evidence to support intervention studies in the future.

Keywords: Cross-sectional study; Delirium; Difficulty; Intensive care unit; Nurses.