Master of Philosophy
School of Nursing
Coyle, Miriam Anne, Exploring how registered nurses assess and identify delirium in older persons in the hospital setting, Master of Philosophy thesis, School of Nursing, University of Wollongong, 2015. http://ro.uow.edu.au/theses/4544
Aim The aim of this study was to explore how Registered Nurses assess and identify delirium to inform education and improved delirium care practices in the healthcare environment of the researcher.
Background Delirium is a common event for older people during a hospital admission (50 per cent). An episode of delirium may cause a range of adverse outcomes for older people: new dementia, worsening dementia, re-location into residential accommodation, and death. The prevention, recognition and management of delirium in hospitals are inadequate and demonstrated to be challenging for nurses. Multi-component interventions including education are recommended as strategies to address these issues. Clinical practice and research provide evidence of the under-recognition of delirium in hospital by medical and nursing clinicians. Although Registered Nurses are key to the provision of delirium care there was scant literature exploring how they assess and identify delirium in older people.
Methods This was a qualitative descriptive study. The setting was a regional referring hospital in New South Wales, Australia, and the participants were Registered Nurses with experience of delirium care. Data collection consisted of in-depth, face-to-face group interviews (n=8). Transcribed and deidentified data underwent thematic analysis concurrent with the data collection.
Findings Registered Nurses (n=24) who worked on surgical, medical, renal, aged care, rehabilitation and emergency units participated in the interviews. A total of three themes were identified to explain how Registered Nurses assess and identify delirium: (1) It’s not my job; (2) It is my job; and (3) It’s complex.
Conclusion and implications for practice The findings demonstrated that hospital delirium care education needs to target Registered Nurses across unit specialties to build mastery in delirium assessment and identification, and reinforce nurses’ integral role in recognising delirium in older persons.