The 2023 World delirium awareness and quality Survey: A Canadian substudy

IF 4.7 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2025-06-01 Epub Date: 2025-03-01 DOI:10.1016/j.iccn.2025.103980

Karla D Krewulak , Laurie A. Lee , Kathryn Strayer , Jennifer Armstrong , Nadia Baig , Judith Brouillette , Kirsten Deemer , Natalia Jaworska , Katherine A Kissel , Christine MacDonald , Tanya Mailhot , Oleska G. Rewa , Eric Sy , Peter Nydahl , Rebecca von Haken , Heidi Lindroth , Keibun Liu , Kirsten M. Fiest

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Abstract

Objective

This study aimed to evaluate the proportion of screened patients with delirium and the strategies used for its management in Canadian hospitals caring for critically ill children or adults.

Methods

This is a secondary analysis of a cross-sectional study completed on World Delirium Awareness Day (March 15, 2023). Respondents completed a 35-question survey on the proportion of screened patients with delirium (at 8:00 am and 8:00 pm), treatment, and management strategies employed.

Results

A total of 27 ICUs (22 adult and 5 pediatric) participated. Among adult ICU patients assessed for delirium, 18 % (n = 34/194) had delirium at 8:00 am and 18 % (32/181) had delirium at 8:00 pm. In pediatric ICUs, the proportion of screened patients with delirium was higher, with 50 % (n = 8/16) at 8:00 am and 44 % (n = 7/16) at 8:00 pm. Delirium management strategies varied: with non-pharmacological approaches such as multi-professional rounds (100 %), pain management (96 %), and mobilization (85 %) being most common. The most reported written delirium management protocols included spontaneous breathing trials in adult ICUs and physical restraint and sedation management in PICUs. Few ICUs reported written protocols for family engagement and empowerment.

Conclusions

Delirium remains a prevalent issue in Canadian ICUs, with variability in assessment and management strategies. Gaps in family engagement and pediatric-specific protocols persist. Addressing barriers like staff shortages and lack of training is critical to improving care.

Implications for Clinical Practice: Improving delirium management requires standardized protocols, especially in PICUs, and better integration of family engagement in care. Addressing workforce challenges (e.g., staff shortages and educating new staff on delirium) will be crucial for enhancing delirium prevention and treatment in Canadian ICUs. Further research should focus on pediatric-specific interventions and pharmacological management.

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2023年世界谵妄意识和质量调查：加拿大子研究

目的本研究旨在评估加拿大医院重症儿童或成人谵妄患者的筛查比例及其管理策略。方法：这是对世界谵妄意识日（2023年3月15日）完成的一项横断面研究的二次分析。受访者完成了一项35个问题的调查，内容涉及筛查的谵妄患者的比例（上午8:00和晚上8:00）、治疗和采用的管理策略。结果共纳入27个icu（成人22例，儿童5例）。在被评估为谵妄的ICU成人患者中，18% （n = 34/194）在上午8点出现谵妄，18%（32/181）在晚上8点出现谵妄。在儿科icu中，筛查的谵妄患者比例更高，上午8:00为50% (n = 8/16)，晚上8:00为44% （n = 7/16）。谵妄的治疗策略多种多样：非药物治疗如多专业查房（100%）、疼痛治疗（96%）和动员治疗（85%）是最常见的。报道最多的书面谵妄管理方案包括成人重症监护病房的自主呼吸试验和picu的物理约束和镇静管理。很少有icu报告了家庭参与和赋权的书面协议。结论谵妄仍然是加拿大icu的一个普遍问题，在评估和管理策略上存在差异。家庭参与和儿科专门协议方面的差距仍然存在。解决人员短缺和缺乏培训等障碍对改善护理至关重要。对临床实践的启示：改善谵妄的管理需要标准化的协议，特别是在picu，以及更好地整合家庭参与护理。解决劳动力挑战（例如，员工短缺和对新员工进行谵妄教育）对于加强加拿大icu的谵妄预防和治疗至关重要。进一步的研究应侧重于儿科特定的干预措施和药理学管理。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.