Exploring the Knowledge, Recognition and Management of Delirium amongst Nursing Home Staff

Abstract

Research into nursing knowledge of delirium has revealed a lack of adequate understanding in a variety of settings. The negative impacts of delirium on older adults are well documented and it is recognized that residents of nursing homes are a high-risk group. Little research so far has explored the knowledge of staff and care processes for the management of delirium within nursing homes. This study aimed to explore the knowledge of delirium and the care processes in place to support residents who may have delirium. An exploratory descriptive qualitative design was adopted, with semi-structured interviews conducted with 20 participants across five nursing homes. Data was analyzed using reflexive thematic analysis. The findings revealed limited knowledge of delirium within the homes, with available clinical guidelines not used. Two themes, each with two associated sub-themes were developed from the data; 1. Misperceptions of delirium with subthemes, its’ infection isn’t it and need for training, and 2. Managing acute confusion; with subthemes knowing the residents and feeling isolated. Whilst there was a lack of knowledge specific to delirium identified, the close relationships staff developed with residents were evident, meaning that staff identified changes in physical and mental health in residents quickly. There is a need to develop appropriate training to ensure that care for delirium is based on evidence-based clinical guidelines and to ensure the quality of care and optimal outcomes for residents.