Perioperative knowledge, self-efficacy and clinical practices related to postoperative delirium care in older people across geographical regions in Australia
Ezinne O. Igwe PhD, Jessica Nealon PhD, Pauline O'Shaughnessy PhD, Callum Ormonde MBBS, Victoria Traynor PhD
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引用次数: 0
Abstract
Introduction
In older people undergoing surgery, there is a lower tolerance for complications. This highlights the need for documented clinical practices on proper prevention, pre-screening and management of complications such as postoperative delirium (POD). Evidence-based clinical practice guidelines exist for delirium management; however, the management of delirium in clinical settings differs widely.
Objective
This study aims to develop an understanding of the knowledge, components of self-efficacy (confidence/competence), and clinical practice related to POD care among preoperative and recovery nurses across different types of geographical locations in Australia.
Design
A 27-item online survey was sent out to professional associations focused on perioperative care across Australia. The participants included practicing registered nurses specialising in perioperative care. The main outcome measures were Knowledge, confidence/competence and clinical practice relating to POD care in older patients.
Findings
Respondents were categorised into two groups—major cities and rural and remote. Mean age was 46.3 years for respondents in Australian major cities and 49.5 for the comparison group. There was a statistically significant difference between Australian major cities and ‘rural and remote’ in confidence in detecting hyperactive delirium, 25.2% versus 11.7% respectively as well as managing hyperactive delirium, 13.8% versus 1.7%, respectively. Similar results were also observed on hypoactive delirium. Respondents from both groups did not mirror the ideal situation in managing a hyperactive delirium.
Discussion
Results from this study are inconclusive and there is no clear-cut observation in clinical practice or knowledge between the two geographical categories in this study.
Conclusion
The absence of a distinct strategy with POD prevention highlights the need for a uniform approach and consensus on POD prevention and management in older people. This can be achieved by creating more awareness and education through professional development related to POD.
导言接受手术的老年人对并发症的耐受力较低。这凸显了对术后谵妄(POD)等并发症的正确预防、预检和管理的临床实践记录的必要性。目前已有基于证据的谵妄管理临床实践指南,但临床环境中对谵妄的管理却大相径庭:本研究旨在了解澳大利亚不同地理位置的术前和恢复期护士对 POD 护理的相关知识、自我效能(信心/能力)和临床实践:设计:向澳大利亚各地专注于围术期护理的专业协会发送了一份包含 27 个项目的在线调查。参与者包括专门从事围手术期护理的执业注册护士。主要结果指标为老年患者 POD 护理的相关知识、信心/能力和临床实践:受访者分为两组--大城市和农村及偏远地区。澳大利亚大城市受访者的平均年龄为 46.3 岁,对比组为 49.5 岁。澳大利亚大城市与 "农村和偏远地区 "的受访者在发现多动谵妄的信心方面存在显著差异(分别为 25.2% 对 11.7%),在处理多动谵妄的信心方面也存在显著差异(分别为 13.8% 对 1.7%)。在低能谵妄方面也观察到了类似的结果。两组受访者在处理多动谵妄时都没有反映出理想的情况:讨论:本研究的结果尚无定论,在临床实践或知识方面,本研究中的两个地域类别之间没有明显的差异:结论:缺乏预防 POD 的独特策略凸显了在老年人 POD 预防和管理方面采取统一方法和达成共识的必要性。要做到这一点,就必须通过与 POD 相关的专业发展,提高人们对 POD 的认识并加强教育。
期刊介绍:
The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.