Evaluating the Feasibility and Clinical Outcome for Assessment Prevention and Management of Acute Delirium in a Surgical Intensive Care Unit
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Abstract: This operation study aimed to study the practical feasibility and outcome for assessment prevention and management of acute delirium in a surgical intensive care unit of Maharaj Nakhon Si Thammarat Hospital. The sample comprised of 2 groups: 21 nurses caring for critically ill patients; and 62 surgical critically ill patients. The study was conducted during February – September 2018. The research instruments were: personal data and illness data records, the evaluation form of practical feasibility, the knowledge assessment on acute delirium, the assessment of nursing process, the assessment of pain, agitation and acute delirium, and procedure manual based on ABCDEF program. Results showed that nurses’ knowledge after program implementation for 1 month was significantly higher than before program implementation (p < .05) which was higher than the targeted outcome (>70%). Of 90.47% of the nurses agreed that the program was feasible in practice. The process of ABCDEF program, patients received complete process on three activities ranged from 79.03-100%. The outcomes after program implementing indicated that most of patients reported low level of pain score. Agitation scores from Day 1 to 7 were increased toward the targeted scores ranged from 65.05% to 75.36%. It was found that 41.93% of patients had acute delirium which consisted of hyperactive, mixed subtype and hypoactive types at the percentages of 22.58%, 16.13%, and 3.22% respectively. The acute delirium was mostly found within Day 1 to 3, at the percentage of 61.54%. This program has the feasibility to implement in critically ill patients. It helps increase nurses’ knowledge in care and patients’ outcomes.
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