Introduction
The phenomenon of interest is clearly stated; the research focuses on delirium, which considerably influences nursing practice in diagnosis and management, with under-detection and inconsistent delirium care being international issues. A qualitative methodology, specifically semi-structured interviews, was employed to investigate nurses’ perspectives on various areas of delirium evaluation and management (Agrar et al., 2012). The study’s purpose is to examine nurses’ assessment and management of delirium when caring for cancer patients, the elderly, or older adults who require mental care in an inpatient environment. The findings have implications for education and knowledge translation, demonstrating the significance of the research.
Methodology
The type of qualitative method used is compatible with the purpose of the study. Semi-structured interviews assist in investigating nurses’ perspectives on recognizing, diagnosing, and monitoring delirium, the causes of distress in patients and families, and their degree of trust in management. Purposive sampling was used, and interviews were conducted until thematic saturation was attained. The researcher describes data collection strategies; for instance, participants’ demographics were obtained, and semi-structured interviews were conducted in person. Two female research registered nurses with considerable clinical palliative care and general nursing expertise but no managerial or clinical roles in any settings interviewed the participants (Agar et al., 2012). Over the 40 participants, data saturation was attained for all four themes, although not for each specialist group for theme four (Management). The data was organized for analysis using NVivo 8, and interviews were performed until no further subjects were raised.
To further comprehend and interpret the findings, a grounded theory approach was employed to build a substantive theory. Thematic content was used to analyze the transcribed material, utilizing a continuous comparative procedure with themes extracted from the data. To confirm the findings and address the credibility and confirmability of the data, an independent review and peer consensus procedure was adopted, with all coders keeping notes on their reasoning and approach to analysis. The data and the initial coding tree were examined by a third researcher who read ten percent of the transcripts to establish consensus and finalize themes.
Findings
The findings were presented with enough context to be clear as the researcher included the participants’ demographics in detail and described the results for the four themes obtained. I am able to understand the experiences presented in the findings. It was demonstrated that nurses, independent of the specialty field, had insufficient knowledge of the features of delirium. Furthermore, delirium was always described as a highly stressful experience for patients, relatives, and professionals.
Conclusions and Implications
The findings in an Australian setting are consistent with previous research indicating a lack of detection of delirium by nurses and other health personnel. Prior studies employing CAM screening by bedside nurses in acute geriatrics found it particularly challenging to identify acute onset, symptom fluctuation, and changed state of awareness, all of which were similarly poorly recognized in the current study. There is one contradiction to prior studies: delirium detection and evaluation were restricted for many participants; the majority were confident in managing and acquiring knowledge through clinical experience.
The recommendations for further study are to determine whether the reasons for delirium under-detection and under-management are comparable in other fields. This plan will guide educational and healthcare services for nurses in delirium treatment, but it may also give some insight into efforts to improve delirium care in other disciplines.
The first fundamental limitation is that an interview approach only provides information about what a health professional claims to perform, which may or may not be immediately applicable in practice. Secondly, the questions contained delirium and disorientation, which may have motivated participation. Finally, while thematic saturation was reached in the entire sample, it was not accomplished for several topics within the various specialized groups. The researcher highlighted the importance of the study by interviewing a diverse group of nurses in a variety of inpatient settings and provided insight into the breadth of decision tasks nurses confront when caring for someone with delirium. The way nurses convey these difficulties to the multidisciplinary team has significance, with delirium considered a vital indication.
Reference
Agar, M., Draper, B., Phillips, P. A., Phillips, J., Collier, A., Harlum, J., & Currow, D. (2012). Making decisions about delirium: a qualitative comparison of decision making between nurses working in palliative care, aged care, aged care psychiatry, and oncology. Palliative Medicine, 26(7), 887-896. Web.