Knowledge and practice gaps in delirium care among ICU nurses: A multicenter study in Jordan

Intensive care unit (ICU) nurses play a critical role in the early recognition and management of delirium; however, gaps between knowledge and clinical practice remain a concern. This study evaluated ICU nurses' knowledge and practices related to delirium and identified associated factors in Jordan.

A cross-sectional study was conducted among 328 ICU nurses from six governmental, military, and private hospitals. Data were collected using the Delirium Awareness and Practice ICU questionnaire. Statistical analysis was performed using SPSS version 26, with independent t-tests and one-way ANOVA used to examine differences in awareness scores.

The mean delirium awareness score was 69.16 ± 7.53, indicating moderate knowledge, with 62.3% scoring below the mean. While most nurses recognized delirium as a serious problem (92.4%) and important in older critically ill patients (98.2%), only 0.9% reported routine monitoring, and none used standardized assessment tools or protocols. More than half perceived delirium as underdiagnosed (56.1%) and as a normal part of ICU hospitalization (65.9%). Knowledge gaps were noted in long-term consequences (40.9%) and modifiable risk factors such as sedative use (37.8%). Antipsychotics were the most commonly reported treatment (60.1%). Higher awareness scores were associated with female gender, bachelor's degree, ≥5 years ICU experience, and reading delirium-related literature (p < 0.001).

Despite moderate knowledge, ICU nurses demonstrated deficiencies in delirium monitoring and evidence-based management. These findings highlight a critical knowledge-practice gap and the need for targeted education and implementation of standardized delirium assessment protocols.