Intervention Effect Study On Delirium Training Based On Experiential Learning Theory Or ICU Nurses

Objective 1.To explore the intervention effects of delirium training of ICU nurses knowledge and assessment ability based on experiential learning.2.To explore the real experience and feelings of ICU nurses who routinely assessed delirium, and provide guidance for the clinical application of routine nurse assessment.Methods Stage Ⅰ:A self-control study. Convenience sampling method was used to recruit 50 nurses of Anhui Provincial Hospital ICU.50 nurses had received the ICU specialist nurse training, including short term delirium education training which combining the multimedia teaching with the traditional teaching method. In this study, 50 ICU nurses were trained based on experiential learning about delirium education for four weeks. The knowledge questionnaires of delirium were conducted before and after training to evaluate the level of nurses’delirium knowledge. ICU nurses assessed patients for three months before and after training, and compared with researchers’ assessment results to analysis the consistency. Stage Ⅱ:A qualitative study. Phenomenon research method was used to interview 12 nurses from the first stage. The date was collected using face to face and in-depth interviews.The date was analysised by Colaizzi method.Results Stage Ⅰ:1. The ICU nurses’level of delirium konwledge had improved after training. Delirium knowledge questionnaire recovery rates before and after training were 100% and the total knowledge scores respectively were 20.56±3.50,28.14±2.34. The difference was statistically significant (P<0.05). There was no statistic difference in the basic concept of delirium(P>0.05).There was statistic differences in delirium subtypes and the incidence,clinical features, risk factors, harm, prevention and treatment measures and assessment tools application(P<0.05). After training,the nurses’ knowledge level in these areas has increased.2. The delirium assessment results by ICU nurses and expert showed that the concordance rates before training was 88.54% and after training was 94.32%. The Kappa values were 0.37 and 0.54. The rate of delirium misdiagnosis was 63.3% before training and after was 50%.After the training of ICU nurses improved accuracy assessment of delirium. Stage Ⅱ:Though exploring the real experience and feelings of ICU nurses who routinely assessed delirium using the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU), three themes were extracted.1. ICU nurses’ knowledge, attitude and behavior have changed.Routine delirium assessment can enhance the nurses’ understanding of knowledge about delirium, fill the cognitive defects for delirium; improve the nurse’s emphasis on delirium and reduce the neglection of delirium.ICU nurses begin to take the initiative to study and consulting skills assessment.2. There are still some difficulties and problems about delirium assessment process. One is the difficult cooperation between doctors, nurses and patients. The second problem is the application of defect assessment tools. The last is the assessment of compliance is not high.3. ICU nurses think that the application prospect of routine delirium assessment well and ICU patients should be received routine delirium assessment.Conclusion The educational training of delirium based on experiential learning for ICU nurses can improve ICU nurses’ knowledge level and the accuracy of delirium assessment. This training can offer some help for ICU nurses to toutine delirium assessment and early identify patients with delirium. But there are still some problems in the application process, which needs further research.