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Abstract

Introduction: Postoperative delirium is a common cognitive complication characterized by an abrupt disturbance in brain function after surgery. It occurs in 15 to 25% of patients undergoing major elective surgeries and up to 50% of patients who have had high-risk procedures such as cardiac surgery or hip fracture repair. Postoperative delirium can result in negative outcomes such as increased healthcare costs, increased length of stay, and lasting cognitive impairment. Although nurses play a critical role in recognizing delirium, the complication remains under-recognized and poorly managed. This finding emphasizes the need for improved delirium recognition and management strategies; therefore, educational initiatives designed to improve delirium care are necessary for nurses caring for patients with this complication. Objectives: This project evaluated the effect of structured delirium education on nursing knowledge, recognition, and management of delirium. Methods: This quality-improvement project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) tool, a 36-item scale divided into three subscales, to evaluate medical-surgical nurses’ knowledge before and immediately following the implementation of an on-demand web-based delirium education module. It was available to nurses from October 2020 through December 2020. Participation in this project was voluntary and consisted of nurses working on two surgical units. Assessment scores were evaluated pre-and post-education and the Wilcoxon signed-rank test was used to detect significant changes. Results: Sixteen nurses participated in the project. Overall mean scores improved from 67.99% on the pre-assessment to 81.84% on the post-assessment. Subscale mean scores also improved and were as follows: knowledge of assessment tools and scales 71.84% pre and 87.5% post, general knowledge of delirium 75.89% pre and 85.71% post, and risk factors for delirium 56.25% pre and 72.32% post. Conclusion: The educational intervention provided in this project increased nurses’ knowledge and recognition of delirium, validating similar findings in the literature. An educational intervention delivered via electronic format is an effective method to provide delirium education to nurses. Improving nursing knowledge of delirium is essential in improving patient outcomes.

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