Factors Affecting Nurses' Ability to Identify Delirium in Acute Care Settings

Area of Science:

• Gerontology
• Nursing Science
• Qualitative Research

Background:

• Delirium is a prevalent yet underrecognized condition in hospitalized older adults.
• Early detection and management are crucial for improving patient outcomes.

Purpose of the Study:

• To explore the clinical reasoning processes acute care nurses use to assess for delirium.
• To understand how nurses detect and respond to delirium symptoms in hospitalized older adults.

Main Methods:

• Qualitative study utilizing dimensional analysis.
• Ten focus groups conducted with 39 experienced nurses from various medical settings.
• Inductive analysis of transcripts with trustworthiness checks.

Main Results:

• Nurses apply clinical reasoning to recognize and manage delirium symptoms.
• Clinical context and social structures significantly influence nurse judgment and decision-making.
• Nurses navigate complex environments to ensure patient safety.

Conclusions:

• Enhancing interdisciplinary knowledge sharing is vital for improving delirium detection and care.
• Supportive environments are necessary to improve care for vulnerable patients experiencing delirium.
• Further research should focus on strategies to reduce delirium severity and duration.