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Clinicians’ Knowledge and Attitudes About Delirium Detection and Management

Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patie...

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Autores principales: Shrestha, Priyanka, Husser, Erica, Berish, Diane, Ngo, Long, Boltz, Marie, Inouye, Sharon, Marcantonio, Edward, Fick, Donna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742666/
http://dx.doi.org/10.1093/geroni/igaa057.1676
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author Shrestha, Priyanka
Husser, Erica
Berish, Diane
Ngo, Long
Boltz, Marie
Inouye, Sharon
Marcantonio, Edward
Fick, Donna
author_facet Shrestha, Priyanka
Husser, Erica
Berish, Diane
Ngo, Long
Boltz, Marie
Inouye, Sharon
Marcantonio, Edward
Fick, Donna
author_sort Shrestha, Priyanka
collection PubMed
description Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patient and increased workload for the clinician. As a part of an NIH funded study testing a rapid two-step delirium identification protocol at two hospitals in the U.S. (one urban and one rural), clinicians completed a 12-item survey to assess their knowledge and attitudes about delirium and their confidence in preventing and managing delirium. Survey response options followed a 5-point rating scale (strongly disagree, disagree, undecided, agree, strongly agree). The sample for this analysis included 399 clinicians (MDs=53; RNs=235; CNAs=111). Chi-square was used to test for group differences between clinician types. Less than half of the clinicians reported agreeing with the statement, “delirium is largely preventable” (MDs: 47%; RN: 44%; CNA: 41%, p-value=0.021). MDs and RNs indicated a high level of confidence in recognizing delirium while CNAs endorsed lower levels of confidence (MDs: 87%; RN: 81%; CNA: 65%, p-value=0.001). All types of clinicians reported lower confidence in managing delirium (MDs: 29%; RN: 36%; CNA: 44%, p-value=0.117). 47% of CNAs and 37% of RNs agreed there is a need for additional training in caring for persons with delirium while only 21% of MDs agreed (p = 0.031). Understanding how different types of clinicians think and feel about delirium will inform training and communication initiatives, clinical implementation, and research on best practices for delirium identification and management.
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spelling pubmed-77426662020-12-21 Clinicians’ Knowledge and Attitudes About Delirium Detection and Management Shrestha, Priyanka Husser, Erica Berish, Diane Ngo, Long Boltz, Marie Inouye, Sharon Marcantonio, Edward Fick, Donna Innov Aging Abstracts Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patient and increased workload for the clinician. As a part of an NIH funded study testing a rapid two-step delirium identification protocol at two hospitals in the U.S. (one urban and one rural), clinicians completed a 12-item survey to assess their knowledge and attitudes about delirium and their confidence in preventing and managing delirium. Survey response options followed a 5-point rating scale (strongly disagree, disagree, undecided, agree, strongly agree). The sample for this analysis included 399 clinicians (MDs=53; RNs=235; CNAs=111). Chi-square was used to test for group differences between clinician types. Less than half of the clinicians reported agreeing with the statement, “delirium is largely preventable” (MDs: 47%; RN: 44%; CNA: 41%, p-value=0.021). MDs and RNs indicated a high level of confidence in recognizing delirium while CNAs endorsed lower levels of confidence (MDs: 87%; RN: 81%; CNA: 65%, p-value=0.001). All types of clinicians reported lower confidence in managing delirium (MDs: 29%; RN: 36%; CNA: 44%, p-value=0.117). 47% of CNAs and 37% of RNs agreed there is a need for additional training in caring for persons with delirium while only 21% of MDs agreed (p = 0.031). Understanding how different types of clinicians think and feel about delirium will inform training and communication initiatives, clinical implementation, and research on best practices for delirium identification and management. Oxford University Press 2020-12-16 /pmc/articles/PMC7742666/ http://dx.doi.org/10.1093/geroni/igaa057.1676 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Shrestha, Priyanka
Husser, Erica
Berish, Diane
Ngo, Long
Boltz, Marie
Inouye, Sharon
Marcantonio, Edward
Fick, Donna
Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title_full Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title_fullStr Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title_full_unstemmed Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title_short Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
title_sort clinicians’ knowledge and attitudes about delirium detection and management
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742666/
http://dx.doi.org/10.1093/geroni/igaa057.1676
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