Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
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Factors Influencing Intensive Care Unit Nurses' Competency in Delirium Care in A Tertiary General Hospital

상급종합병원 중환자실 간호사의 섬망간호역량 영향요인

  • Lim, Mi Ran (Pusan National University Hospital) ;
  • Cho, Gyoo Yeong (Department of Nursing, Pukyong National University)
  • 임미란 (부산대학교병원 ) ;
  • 조규영 (국립부경대학교 간호학과 )
  • Received : 2024.08.20
  • Accepted : 2024.10.02
  • Published : 2024.10.31
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Abstract

Purpose : In this study, we aimed to identify the factors affecting nurses' competency in delirium care in an intensive care unit at a tertiary general hospital. Methods : The participants were 149 nurses in the intensive care unit. Collected data were analyzed using independent t-tests, ANOVA, Sheffé test, Pearson correlations coefficients, and multiple regressions using the SPSS 28.0 program. Results : The factors that significantly influenced the participants' competency in delirium care were delirium nursing confidence (𝛽=.44, p <.001) and intensive care unit clinical career (𝛽=.25, p =.002). These factors explained 32.5% of the total variance outcomes regarding the competency in delirium care (F=12.87, p <.001). Conclusion : The study results indicated that the higher the confidence in delirium care and the more extensive intensive care unit experience, the higher the competency in delirium care. Moreover, these results suggested that various policy strategies should be implemented to enable intensive care unit nurses to work for a long time and to develop educational programs to increase confidence in delirium care.

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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 2019. 
  2. Gregory KA. Easy as ABC: How staff nurses transformed unit culture to assess and manage delirium in the intensive care unit. Critical Care Nurse. 2016;36(5):73-6. https://doi.org/10.4037/ccn2016821 
  3. Jung JY, Jang SJ, Jo SM, Lee SH. Delirium experience of the intensive care unit patients. Journal of Korean Academy of Nursing. 2022;52(2):134-43. https://doi.org/10.4040/jkan.21240 
  4. Health Insurance Review & Assessment Service. Statistics of inpatients in the intensive care unit [Internet]. Wonju: Health Insurance Review & Assessment Service; 2021 [cited 2021 October 05]. Available from: https://www.data.go.kr/data/15052314/fileData.do 
  5. Jeong IS, Cho MK. Factors affecting delirium in ICU patients. International Journal of Environmental Research and Public Health. 2023;20(10):5889. https://doi.org/10.3390/ijerph20105889 
  6. Spiegelberg J, Song H, Pun B, Webb P, Boehm LM. Early identification of delirium in intensive care unit patients: Improving the quality of care. Critical Care Nurse. 2020;40(2):33-43. https://doi.org/10.4037/ccn2020706 
  7. Shim MY, Hee SS, Mi LM, Ah PM, Jin YE, Soo KM, et al. The effects of delirium prevention intervention on the delirium incidence among postoperative patients in a surgical intensive care unit. Journal of Korean Clinical Nursing Research. 2015;21(1):43-52. https://doi.org/10.22650/JKCNR.2015.21.1.43 
  8. Thomas N, Coleman M, Terry D. Nurses' experience of caring for patients with delirium: Systematic review and qualitative evidence synthesis. Nursing Reports. 2021;11(1):164-74. https://doi.org/10.3390/nursrep11010016 
  9. Fowler BM. Clinical education to decrease perceived barriers to delirium screening in adult intensive care units. Critical Care Nursing Quarterly. 2019;42(1):41-3. https://doi.org/10.1097/cnq.0000000000000235 
  10. Mrayyan MT, Abunab HY, Abu Khait A, Rababa MJ, Al-Rawashdeh S, Algunmeeyn A, et al. Competency in nursing practice: a concept analysis. BMJ Open. 2023;13(6):e067352. https://doi.org/10.1136/bmjopen-2022-067352 
  11. Roh YS. The training needs of Korean intensive care unit nurses regarding delirium. Intensive and Critical Care Nursing. 2021;62:102954. https://doi.org/10.1016/j.iccn.2020.102954 
  12. Zamoscik K, Godbold R, Freeman P. Intensive care nurses' experiences and perceptions of delirium and delirium care. Intensive and Critical Care Nursing. 2017;40:94-100. https://doi.org/10.1016/j.iccn.2017.01.003 
  13. Schmitt EM, Gallagher J, Albuquerque A, Tabloski P, Lee HJ, Gleason L, et al. Perspectives on the delirium experience and its burden: Common themes among older patients, their family caregivers, and nurses. The Gerontologist. 2019;59(2):327-37. https://doi.org/10.1093/geront/gnx153 
  14. Seo HJ, Yoo YS. Intensive care unit nurse's knowledge, nursing performance, and stress about delirium. Korean Journal of Adult Nursing. 2007;19(1):55-65. 
  15. Park YS. The Development and effects of evidence-based nursing practice guideline for the nursing of delirium in cancer patients [dissertaion]. Jinju: Gyeongsang University; 2011. 
  16. Nydahl P, Dewes M, Dubb R, Hermes C, Kaltwasser A, Krotsetis S, et al. Survey among critical care nurses and physicians about delirium management. Nursing in Critical Care. 2018;23(1):23-9. https://doi.org/10.1111/nicc.12299 
  17. Staveski SL, Pickler RH, Lin L, Shaw RJ, Meinzen-Derr J, Redington A, et al. Management of pediatric delirium in pediatric cardiac intensive care patients: An international survey of current practices. Pediatric Critical Care Medicine. 2018;19(6):538-43. https://doi.org/10.1097/pcc.0000000000001558 
  18. Krupa S, Friganovic A, Oomen B, Benko S, Medrzycka-Dabrowska W. Nurses' knowledge about delirium in the group of intensive care units patients. International Journal of Environmental Research and Public Health. 2022;19(5):2758. https://doi.org/10.3390/ijerph19052758 
  19. Aldawood ZS, Alameri RA, Elghoneimy Y, Swyan AHA, Almulla H, Hammad SS, et al. Impact of educational program on critical care nurses' knowledge of ICU delirium: A quasi-experimental study. Journal of the Academy of Medical Sciences of Bosnia and Herzegovina. 2023;77(1):56-63. 
  20. Akechi T, Ishiguro C, Okuyama T, Endo C, Sagawa R, Uchida M, et al. Delirium training program for nurses. Psychosomatics. 2010;51(2):106-11. https://doi.org/10.1016/S0033-3182(10)70670-8 
  21. Kim HJ, Song EJ. Factors influencing the nursing performance of delirium care in intensive care unit nurses. The Journal of Social Convergence Studies. 2023;7(2):1-12. https://doi.org/10.37181/JSCS.2023.7.2.001 
  22. Kim MJ, Lee HJ. The effects of delirium care training program for nurses in hospital nursing units. Korean Journal of Adult Nursing. 2014;26(5):489-99. http://doi.org/10.7475/kjan.2014.26.5.489 
  23. Kim NY, Ryu SA, Kim YH. Factors related to delirium of intensive care unit patients in Korea: A systematic review. Iranian Journal of Public Health. 2021;50(8):1526-35. https://doi.org/10.18502/ijph.v50i8.6798 
  24. Tachibana M, Inada T, Ichida M, Ozaki N. Risk factors for inducing violence in patients with delirium. Brain and Behavior. 2021;11(8):e2276. https://doi.org/10.1002/brb3.2276 
  25. Wang Y, Li L, Tan S, Guan Y, Luo X. Psychological stress and associated factors in caring for patients with delirium among intensive care unit nurses: A cross-sectional study. Australian Critical Care. 2023;36(5):793-8. https://doi.org/10.1016/j.aucc.2022.09.006 
  26. Kim HY, Kim SO. The effect of nurses' knowledge and self-confidence on delirium nursing performance of nurses in an integrated nursing and caring services ward: A cross-sectional descriptive study. Journal of Korean Gerontological Nursing. 2024;26(1):80-90. https://doi.org/10.17079/jkgn.2023.00234 
  27. Kim EH. Relationship between knowledge, stress, and nursing performance about care for delirium in geriatric hospital nurses. Journal of Korean Clinical Health Science. 2016;4(2):593-602. https://doi.org/10.15205/kschs.2016.6.30.593 
  28. Han SS, Sohn IS, Kim NE. New nurse turnover intention and influencing factors. Journal of Korean Academy of Nursing. 2009;39(6):878-87. https://doi.org/10.4040/jkan.2009.39.6.878 
  29. Park HM, Chang MY. Nurse's knowledge, confidence and performance on care for delirium. Journal of Health Informatics and Statistics. 2016;41(4):359-68. https://doi.org/10.21032/jhis.2016.41.4.359 
  30. Cho GR. ICU nurses' knowledge and nursing performance of intensive care unit syndrome [master's thesis]. Seoul: Ewha Womans University; 2001. 
  31. Kim YT. Relationship between stressors and the degree of social support in intensive care unit nurses [master's thesis]. Seoul: Hanyang University; 1989. 
  32. Kang JS, Song HJ. Factors affecting the performance of nurses in delirium care. Journal of Korean Critical Care Nursing. 2019;12(1):13-21. https://doi.org/10.34250/jkccn.2019.12.1.13 
  33. Kim JY, Lee EJ. Factors affecting nursing performance of delirium for general hospital clinical nurses. Journal of Korean Clinical Nursing Research. 2016;22(2):183-93. https://doi.org/10.22650/JKCNR.2016.22.2.183 
  34. Jiang T, Tung TH, Wang Y, Zheng XT, Jia L, Zhang W. Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study. Australian Critical Care. 2024;37(4):530-8. https://doi.org/10.1016/j.aucc.2023.12.004 
  35. Park YS, Kim KS, Song KJ, Kang JY. A preliminary survey of nurses' understanding of delirium and their need for delirium education: in a university hospital. Journal of Korean Academy of Nursing. 2006;36(7):1183-92. https://doi.org/10.4040/jkan.2006.36.7.1183 
  36. Health Insurance Review & Assessment Service. 2019 Intensive care unit adequacy assessment [Internet]. Wonju: Health Insurance Review & Assessment Service; 2021 [cited 2023 November 11]. Available from: https://www.hira.or.kr/cms/open/04/04/12/2020_12.pdf 
  37. Jeong LS, Lee SJ, Shin DS. Factors influencing length of intensive care unit among older patients transferred from long term care hospital. Journal of Health Informatics and Statistics. 2020;45(4):341-8. https://doi.org/10.21032/jhis.2020.45.4.341 
  38. Lange S, Medrzycka-Da Browska W, Tomaszek L, Wujtewicz M, Krupa S. Nurses' knowledge, barriers and practice in the care of patients with delirium in the intensive care unit in Poland-A cross-sectional study. Frontiers in Public Health. 2023;11:1119526. https://doi.org/10.3389/fpubh.2023.1119526 
  39. Choi JI, Kim JH, Park JY. Delirium screening, delirium knowledge, and delirium care among hospital nurses at a tertiary hospital based on postoperative delirium cases. Journal of Korean Clinical Nursing Research. 2022;28(2):157-66. https://doi.org/10.22650/JKCNR.2022.28.2.157 
  40. Norman SL, Taha AA. Delirium knowledge, self-confidence, and attitude in pediatric intensive care nurses. Journal of Pediatric Nursing. 2019;46:6-11. https://doi.org/10.1016/j.pedn.2019.01.013