Introduction: There is much evidence about best practice delirium care but yet delirium remains undetected, mis-diagnosed and mis-managed. Older people are more likely than other population groups to experience a delirium, in particular individuals living with a dementia. One way to prevent delirium and reduce its effects is for clinicians to develop their competence to recognise delirium and develop skills in preventing and managing delirium.
Purpose: Evaluate the effects of an interactive delirium care education intervention
on delirium care for older people in acute healthcare settings.
Methods: This study used a multi-method quasi-experimental design with pre-and post-intervention and observation to evaluate clinicians’ skill, confidence and competence after education package and OSCEs.
Sample and settings: A convenience sample of all registered nurses, enrolled nurses, medical interns, physiotherapists and occupational therapists working on the four aged care units in two hospitals in NSW, Australia (one regional and one urban). Approximately 150 clinical practitioners were invited to participate in the study.
Data analysis: Data was downloaded into Excel for data cleaning and imported to SPSS for data analysis. Descriptive statistics (including Chi-Squared) will be undertaken to test the effects of implementing the education intervention. The transcripts of data from the open-end questions were analysed independently by two authors using constant comparison method.
Results: The most important findings were statistically significant improvements in the regional hospital perceived: (i) perceived knowledge about delirium (P≤ 0.000) and (ii) perceived confidence of practitioners in using the Confusion Assessment Method (P≤ 0.000). However, there was no increase in confidence and competence in the assessment and management of delirium and in the use of CAM in the urban hospital. Since the participants from the urban hospital are all working in the age specific wards and have more experience in caring for delirium patients, it is not surprising that participants have higher confidence and competence at the baseline but this slightly decreased 6 weeks after post intervention. From qualitative results we found that all participants were highly satisfied regarding their experience of OSCEs session and video viewing of interaction, assessment and management of a delirious patient.
Conclusion: The results of this study showed a significant increase in the participants’ knowledge in recognising delirium and increased confidence and competence in the use of CAM. The study indicates the use of an OSCE in the clinical setting with post-registration nurses and allied health staff may improve the rate of recognition for people at risk of delirium. Therefore future research into this project will include a review of in-patient records on the inclusion of the completed CAM in admission documentation.