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A questionnaire survey about physicians' and nurses' opinions regarding delirium management in hospitalised patients
Verstraete, L., Joosten, E., Milisen, K.; representing the delirium working party of the University Hospitals of Leuven
Aim:
Assessment of the current opinions of physicians and nurses regarding the prevention, diagnosis and management of delirium.
Methodology:
Survey administration was conducted to 2256 nurses and 982 physicians within the University Hospitals of Leuven (Belgium). A panel of experts translated and adjusted an existing questionnaire (Ely et al., 2004).
Results:
Response rate was 26% of which 819 respondents (600 nurses; 219 physicians) completed the questionnaire. 72 % of the respondents considered delirium as a minor problem or no problem at all. Yet over half of respondents working on a palliative care unit (87%, n=15), traumatological ward (67%, n=17), cardio-thoracic surgery ward (58%, n=20), intensive care unit (55%, n=120) and geriatric ward (55%, n=42) reported it as a serious problem.
Delirium was considered as an underdiagnosed (85%) but preventable (74%) syndrome. Yet patients at risk are rarely (34%) or never (52%) screened for delirium. In case of screening, only 5% used a specific validated assessment tool.
96 % of the respondents were convinced that delirium requires an active and immediate intervention of the nurse and physician. 82% of the physicians preferred haloperidol to treat delirium. In case of alcohol withdrawal 85% chose benzodiazepines.
Physical restraints were considered important in the management of delirium by a greater proportion of nurses (49%) than physicians (28%).
Conclusion:
The importance of delirium is underestimated. While opinions regarding the treatment were quite correct, prevention and early detection of delirium deserve more attention. More concern is needed to the use of validated screening tools and education.
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