Early-Career Registered Nurses' Experiences of Implementing Non-Pharmacological Interventions for Delirium Management: A Qualitative Descriptive Study

早期注册护士在谵妄管理中实施非药物干预的经验:一项定性描述性研究

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Abstract

AIM: This study aims to describe early-career registered nurses' experiences of using non-pharmacological interventions for delirium management in general medicine. BACKGROUND: Non-pharmacological interventions are recommended for delirium management, but implementation can be challenging because of the complex and time-consuming nature of delirium behaviours. DESIGN: This study employs a qualitative exploratory descriptive design. METHODS: Semi-structured interviews and focus groups were conducted between May and June 2022 with early-career registered nurses from general medical wards of two hospitals in Australia. Transcripts were analysed using thematic analysis in NVivo. RESULTS: Twenty-two nurses participated. Two conceptual areas with seven themes were identified: factors that prepare and support nurses, which include (1) comprehensive education that supports readiness to manage delirium, (2) accessing the expertise of colleagues and (3) valuing family as essential in delirium care; and experiences of applying knowledge to manage delirium, which include (4) enacting delirium care within the context of the work environment, (5) nurses' use of non-pharmacological interventions, (6) communicating through the confusion and (7) managing escalating behavioural symptoms for safety. CONCLUSIONS: This study highlights the elements needed to prepare and support early-career nurses in delirium care. Delirium care is complex, and nurses identified the need for more preparatory education. Support from experienced nurses and family was essential for delirium management, de-escalation of behavioural symptoms and safety.

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