by
Else Berit Steinseth, Sevald Høye, Reidun Hov
Intensive and
Critical Care Nursing – in press
Mechanically
ventilated patients are at risk of developing delirium, which increases
mortality and prolongs their stay in the Intensive Care Unit (ICU).
Abstract
Background
Mechanically
ventilated patients are at risk of developing delirium, which increases
mortality and prolongs their stay in the Intensive Care Unit (ICU).
Aim
To
investigate the assessment of delirium by ICU nurses and their experiences of
using the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) in mechanically
ventilated patients during daily sedation stops.
Methods
The study
employed an explanatory sequential mixed-methods design. The data (n = 30) were
collected by two nurses who assessed the same patient (n = 15) using the tool.
Data from the nurses’ assessments were analysed by means of frequency analysis,
while the interviews were analysed phenomenographically using Dahlgren and
Fallberg’s seven categories.
Findings
Four pairs
of nurses made similar assessments, three pairs had differing assessments and
in eight pairs, one of the nurses did not fill in the form properly. The
interviews revealed variations in ICU nurses’ preparation for, views on and use
of the CAM-ICU.
Conclusion
Assessment
and use of the CAM-ICU revealed variations, indicating the necessity of
identifying barriers within the ICU team. ICU nurses need training in the use
of the CAM-ICU and support in their decision–making. The individual nurse must
take responsibility for updating their knowledge and for following guidelines.
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