Exploring ICU Nurses’ Experiences in Delirium Screening using CAM-ICU: A Thematic Analysis
DOI:
https://doi.org/10.31674/mjn.2026.v17i04.010Abstract
Background: Delirium is a common but under-identified complication in critically ill patients in intensive care units (ICUs). It leads to long hospital stays, high mortality, and high health care expenditure. Even though the Confusion Assessment Method of the ICU (CAM-ICU) is an instrument that has been validated to be used in the early detection, it is not regularly implemented in real practice. In Malaysia, there is little research on the experience of the ICU nurses as it relates to delirium screening after systematic educational programs. Methods:
This qualitative descriptive research study helped to understand the experience of ICU nurses who took part in a structured CAM-ICU educational intervention. Purposive sampling was used to select six ICU nurses in two privately owned tertiary hospitals in Johor, Malaysia. Interviews were done in a semi-structured format and transcribed verbatim. Member checking, peer debriefing, and audit trail maintenance were used to guarantee rigor. The data collection process was completed until thematic saturation was reached. Results:
Four general themes were identified, namely: issues in delirium screening, increased awareness about the significance of delirium, change in attitudes after education, and suggestions about how to help maintain screening habits. The barriers identified by the participants included the level of patient sedation and the large workload. Nevertheless, they also noted that they felt more confident, more motivated, and became more aware of the situation following the intervention. Peer support and managerial reinforcement were found to be significant to practice change maintenance. Conclusion: The CAM-ICU educational intervention in a structured form enhanced the knowledge and attitudes of the ICU nurses with regard to delirium assessment. Institutional commitment, workflow integration, periodic refresher training, and leader support are needed to maintain the implementation over a long period of time. Delirium screening in routine documentation and encouraging team-based interactions can contribute to long-term sustainability and could result in better patient outcomes.
Keywords:
CAM-ICU;, Delirium Screening;, Educational Intervention;, ICU Nursing;, Thematic AnalysisDownloads
References
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