Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11450
Title: A questionnaire survey of critical care nurses' attitudes to delirium assessment before and after introduction of the CAM-ICU.
Authors: Eastwood, Glenn M;Peck, Leah;Bellomo, Rinaldo;Baldwin, Ian;Reade, Michael C
Affiliation: Department of Intensive Care Medicine, The Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia
Issue Date: 26-Feb-2012
Citation: Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses 2012; 25(3): 162-9
Abstract: Nurses are usually the first to identify delirium in ICU patients. We aimed to assess the attitudes of Australian critical care nurses when we introduced the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).We surveyed all 174 nurses in our ICU using two questionnaires: first after a one-month period of mandated but unstructured delirium assessments, and then following one month of CAM-ICU assessments. We also quantified antipsychotic medication usage by inspecting pharmacy records.The first survey response rate was 65/174 (37%). Most nurses (73%) thought active delirium assessment was important, and 93% thought their assessments were worth the time required. These assessments were largely unstructured, as only 20% knew a formal delirium test, and only 7% sometimes used one. The second survey response rate was 45/174 (26%). Most (89%) still thought delirium assessment was important, but only 75% thought the CAM-ICU worth the time required (p=0.01 compared to unstructured assessments). Similar proportions (75% and 73%) were confident in the accuracy of their assessments. Many (33%) found the CAM-ICU 'quite' or 'very' hard to perform, but despite this, 82% wanted to continue to use it. Free-text answers suggested this was because medical staff paid more attention to the CAM-ICU. Supporting this, prescriptions of antipsychotic medications increased significantly in the CAM-ICU period.Critical care nurses in our Australian ICU who responded to our survey think delirium assessment is important. Although they find unstructured assessments easier to perform, they wanted to persist with the CAM-ICU, in part because it facilitated more appropriate pharmacological treatment of delirium for their patients. We recommend the CAM-ICU as a tool to improve communication between nurses and physicians in the management of delirium.
Internal ID Number: 22370551
URI: http://ahro.austin.org.au/austinjspui/handle/1/11450
DOI: 10.1016/j.aucc.2012.01.005
URL: http://www.ncbi.nlm.nih.gov/pubmed/22370551
Type: Journal Article
Subjects: Aged
Clinical Nursing Research
Critical Care
Delirium.diagnosis
Female
Health Knowledge, Attitudes, Practice
Humans
Intensive Care.methods
Intensive Care Units
Male
Mass Screening.methods
Middle Aged
Needs Assessment.organization & administration
Nursing Assessment.methods
Questionnaires
Appears in Collections:Journal articles

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