Delirium
Conditions
Keywords
Intensive Care Unit Syndrome, Delirium, OSCE
Brief summary
Delirium is a disturbance in consciousness with reduced ability to focus, sustain, or shift attention that occurs over a short period of time and tends to fluctuate over the course of the day. 50% to 81.7% had delirium during their ICU hospitalization. Delirium is associated with increased physical restraint, ventilation use, length of ICU stay, and mortality. However, there is no established delirium care pathway in target hospital. Chen et al. (2014) demonstrated that structured assessment stations with immediate feedback may improve overall learning efficiency over an EBP workshop alone. However, no published delirium care education study has used OSCEs as an intervention for healthcare professionals. The aim is to evaluate the effects of implementing a Scenario- based education intervention, including objective structured clinical examinations (OSCEs) on delirium care among healthcare professionals. This is a knowledge translation research, builds on eight years of delirium care research in University of Wollongong, Australia. The research will be undertaken at ICUs in a medical center in northern of Taiwan. There are two phases: (1) systematic review to identify delirium screen tool, and (2) a randomized controlled trial was conducted to determine the effects of implementing a Scenario-based education intervention, including OSCE (experimental group), and on-line education only (control group) focused on recognition and management of delirium. The hypothesis is: Scenario-based education intervention, including OSCE can increase the competence and self-efficacy among healthcare professionals in delirium care.
Detailed description
OSCEs are an integral aspect of all levels of medical education but limited to undergraduate nursing and allied health education. OSCEs are rarely used in the workplace as learning activities with nursing and allied health clinicians. This is the reason why this education initiative was innovative. OSCEs are simulated 'real life' clinical scenarios presented to clinicians who are required to demonstrate to an assessor the clinical tasks which form an OSCE scenario.
Interventions
BEHAVIORALOSCEs
Scenario-based education intervention, including objective structured clinical examinations (OSCEs)
BEHAVIORALLecture
Face-to-face Education using Delirium Care Flip Chart
BEHAVIORALE-learning
Delirium care video
Sponsors
Taipei Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Registered nurse worked in acute care unit and care with critical patients 2. Licensed physician which undertake the post graduate year program worked in acute care unit and care with critical patients
Exclusion criteria
1.Unwilling to involved the research
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Delirium Knowledge | T0(Baseline), T1(Immediately after the intervention), T2(Six weeks after the intervention) | 1. The ICU Delirium Care Knowledge Quiz (Traditional Chinese version ) developed by Ho et al. (2021) was used in this study. 2. The ICU Delirium Care Knowledge Quiz (Traditional Chinese version ) consists of 16 multiple-choice questions, with 1 point awarded for each correct answer, and a maximum score of 16 points. The total score of the participants is analyzed as a continuous variable. The total range from 0 to 16 (minimum score: 0 point; and maximum score 16 points). Higher points represent better ICU Delirium Care Knowledge. 3. The overall KR-20 coefficient of the questionnaire is 0.85, the intra-class correlation coefficient over a 30-day interval is 0.97, the content validity index (CVI) is 83%, and the exploratory factor analysis (EFA) demonstrates appropriate structural validity, with four factors explaining 60.87% of the total variance, indicating good reliability and validity. |
Countries
Taiwan
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Experimental Group 1. face-to-face delirium care session (30 minutes in duration);
2. online learning delirium care activities (20 minutes in duration); and
3. delirium care OSCE and reflective activity (30 minutes in duration).
OSCEs: Scenario-based education intervention, including objective structured clinical examinations (OSCEs)
Lecture: Face-to-face Education using Delirium Care Flip Chart
E-learning: Delirium care video | 59 |
| Control Group 1. face-to-face delirium care session (30 minutes in duration);
2. online learning delirium care activities (20 minutes in duration)
Lecture: Face-to-face Education using Delirium Care Flip Chart
E-learning: Delirium care video | 38 |
| Total | 97 |
Baseline characteristics
| Characteristic | Experimental Group | Control Group | Total |
|---|---|---|---|
| Age, Customized 20-24 year-old | 16 Participants | 9 Participants | 25 Participants |
| Age, Customized 25-34 year-old | 39 Participants | 25 Participants | 64 Participants |
| Age, Customized 35-44 year-old | 3 Participants | 2 Participants | 5 Participants |
| Age, Customized 45-54 year-old | 1 Participants | 2 Participants | 3 Participants |
| Education Associate Degree | 9 Participants | 5 Participants | 14 Participants |
| Education Bachelor Degree | 49 Participants | 32 Participants | 81 Participants |
| Education Master Degree | 1 Participants | 1 Participants | 2 Participants |
| ICU training No | 8 Participants | 4 Participants | 12 Participants |
| ICU training Yes | 51 Participants | 34 Participants | 85 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 59 Participants | 38 Participants | 97 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 55 Participants | 37 Participants | 92 Participants |
| Sex: Female, Male Male | 4 Participants | 1 Participants | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 59 | 0 / 38 |
| other Total, other adverse events | 0 / 59 | 0 / 38 |
| serious Total, serious adverse events | 0 / 59 | 0 / 38 |
Outcome results
Primary
Delirium Knowledge
1. The ICU Delirium Care Knowledge Quiz (Traditional Chinese version ) developed by Ho et al. (2021) was used in this study. 2. The ICU Delirium Care Knowledge Quiz (Traditional Chinese version ) consists of 16 multiple-choice questions, with 1 point awarded for each correct answer, and a maximum score of 16 points. The total score of the participants is analyzed as a continuous variable. The total range from 0 to 16 (minimum score: 0 point; and maximum score 16 points). Higher points represent better ICU Delirium Care Knowledge. 3. The overall KR-20 coefficient of the questionnaire is 0.85, the intra-class correlation coefficient over a 30-day interval is 0.97, the content validity index (CVI) is 83%, and the exploratory factor analysis (EFA) demonstrates appropriate structural validity, with four factors explaining 60.87% of the total variance, indicating good reliability and validity.
Time frame: T0(Baseline), T1(Immediately after the intervention), T2(Six weeks after the intervention)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Experimental Group | Delirium Knowledge | T0 | 12.40 point | Standard Deviation 1.72 |
| Experimental Group | Delirium Knowledge | T1 | 13.08 point | Standard Deviation 1.69 |
| Experimental Group | Delirium Knowledge | T2 | 13.10 point | Standard Deviation 1.81 |
| Control Group | Delirium Knowledge | T1 | 12.71 point | Standard Deviation 2.02 |
| Control Group | Delirium Knowledge | T2 | 13.78 point | Standard Deviation 1.33 |
| Control Group | Delirium Knowledge | T0 | 13.26 point | Standard Deviation 1.5 |