Turning education into action: Impact of a collective social education approach to improve nurses' ability to recognize and accurately assess delirium in hospitalized older patients. (March 2018)

• Record Type: Journal Article
• Authors: Travers, Catherine; Henderson, Amanda; Graham, Fred; Beattie, Elizabeth
• Is Part Of: Nurse education today. Volume 62(2018)
• Page Start: 91
• Page End: 97
• Publication Date: 2018-03
• Subjects: Dementia -- Delirium -- Hospitals -- Education -- Nursing; Nursing -- Study and teaching -- Periodicals; Education, Nursing -- Periodicals; Soins infirmiers -- Étude et enseignement -- Périodiques; Nursing -- Study and teaching; Periodicals; 610.7307
• DOI: 10.1016/j.nedt.2017.12.026
• Languages: English
• ISSNs: 0260-6917

Abstract

Abstract: Background: Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. Methods: Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium. At the outset, the CogChamps were provided with comprehensive education about dementia and delirium from a multidisciplinary team of clinicians. Their knowledge was assessed to ascertain they had the requisite understanding to engage in education as a collective social process, namely, with each other and their local teams. Following this, they developed ward specific Action Plans in collaboration with their teams aimed at educating and evaluating ward nurses' ability to accurately assess and care for patients for delirium. The plans were implemented over five months. The broader nursing teams' knowledge was assessed, together with their ability to accurately assess patients for delirium. Results: Each ward implemented their Action Plan to varying degrees and key achievements included the education of a majority of ward nurses about delirium and the certification of the majority as competent to assess patients for delirium using the Confusion Assessment Method. Two wards collected pre-and post-audit data that demonstrated a substantial improvement in delirium screening rates. Conclusion: The education process led by CogChamps and supported by educators and clinical experts provides an example of successfully educating nurses about delirium and improving screening rates of patients for delirium. Trial Registration: ACTRN 12617000563369. Highlights: A social collective approach led by Nurse Champions effectively educated hospital nurses about delirium. The intervention resulted in improved screening rates for delirium. The model provides an example of successfully empowering Nurses to lead practice change initiatives.