Empowering nurses in delirium knowledge, recognition, and assessment: A systematic review and meta-analysis of...

To synthesise and examine available evidence on the impacts of nurse-based educational interventions for delirium on improving educational outcomes (primary outcomes included delirium knowledge, recognition, and assessment, while secondary outcomes included confidence and self-efficacy).

A quantitative systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines and were registered with PROSPERO (CRD42025592767).

A comprehensive search across eight databases (from inception to 22 Sept 2024) identified randomised controlled and quasi-experimental studies on nurse-based delirium education. Following screening, data extraction, and independent quality appraisal, a meta-analysis was performed to synthesise outcomes. Sensitivity and subgroup analyses further explored the effects, while the GRADE approach assessed the overall quality of the evidence, ensuring a rigorous and transparent evaluation of intervention effectiveness.

This review included 30 studies, which registered a total of 2734 nurses, with sample sizes ranging from 17 to 618. The meta-analysis revealed a statistically significant increase in delirium knowledge and recognition among participants compared to the control group. Intervention effects on confidence were statistically insignificant. Narrative reviews suggested improvements in nurses' delirium assessment and self-efficacy. The overall quality of evidence was very low for all outcomes.

Evidence on nurse-based delirium education suggests potential benefits in improving knowledge and recognition; the impacts on confidence remain unclear. However, because confidence in the effect estimates is low, the results should be interpreted with caution. While narrative review findings were promising, they were largely inconclusive. Considerable heterogeneity and very low evidence quality among the included studies necessitate cautious interpretation. High-quality research is needed to validate efficacy and identify optimal educational delivery methods and approaches for future practice.

Findings highlight the importance of sustained investment in nurse-based delirium education to enhance knowledge, recognition, and assessment. Multimodal, clinically integrated approaches should be prioritised to optimise learning, while strong institutional and educational support are essential to bolster nurses' confidence and self-efficacy in delirium management.