Evaluation of an Intervention With Nurses for Delirium Detection After Cardiac Surgery

Completion of a delirium detection tool allows rapid management, which alleviates complications. However, these tools are often underused.

To assess the effect of a knowledge transfer (KT) intervention on the completion of a delirium detection tool by nurses working with cardiac surgery patients. Secondary aims included describing completion rates per work shift, and patient characteristics associated with higher rates.

In a pre-post study, the intervention included a survey and focus groups to identify barriers to use of a delirium detection tool (Intensive Care Delirium Screening Checklist [ICDSC]). Nurses' suggestions for a KT activity and its implementation were also included. Using chi-square analysis and medical charts from 242 patients, we compared the pre- and postintervention rates of completion of the ICDSC.

The majority of nurses who completed the survey (n = 30) felt they had the knowledge, skills, and intention to complete the ICDSC. During the focus groups (n = 4), a need for information on delirium symptoms and its management was raised as a barrier. This barrier was addressed with the selected KT activity (clinical capsule and aide-memoire handed out to nurses [n = 24]). Across all work shifts, the completion rate was similar pre- and postintervention. Overall, the completion rate was lower during the day shift than the night and evening shifts. A higher rate was associated with the first three postoperative days, and longer hospital and intensive care unit stays.

A tailored intervention based on preidentified barriers and facilitators, using the Determinants of Implementation Behavior Questionnaire, and in collaboration with participants, has the potential to promote evidence-based practice.