Effects of DELIMA education programme on nurses' knowledge, confidence, attitude, and screening accuracy for delirium in paediatric intensive care units

Objective: To evaluate the effects of a 4-week Delirium Introduction and Maintenance programme based on the knowledge-to-action framework on nurses' knowledge, self-confidence, attitudes, and screening accuracy for delirium in the paediatric intensive care unit (PICU).

Research methodology/design: A quasi-experimental study with a pretest-posttest design.

Setting: This study was conducted between January and February 2024 with nurses in two Indonesian PICUs.

Main outcome measures: Nursing knowledge, self-confidence and attitudes were measured at baseline and the third and fourth weeks (maintenance period) after the intervention was implemented. The Cornell Assessment of Pediatric Delirium (CAPD) was used to evaluate the screening accuracy for delirium at the third and fourth weeks postintervention.

Results: A total of 44 nurses with a mean age of 28 years participated in the intervention. At weeks 3 and 4 after the intervention, the intervention group exhibited substantial improvements in knowledge (B = 1.35 and 1.39), self-confidence and attitudes (B = 1.26 and 1.29), and screening accuracy (B = 0.25 and 0.27) compared with the control group (all P < 0.05). The nurses' screening accuracy for delirium by using the CAPD improved from 50 % (week 1) to 86 % (week 3) and 100 % (week 4) in the intervention group, whereas the nurses' screening accuracy for delirium in the control group modestly increased from 17 % to 33 % (week 3) and 37 % (week 4).

Conclusions: The theory-driven, multimodal intervention improved the nurses' knowledge of delirium, self-confidence and attitudes, and screening accuracy for delirium. Implementing comprehensive delirium education programmes can enhance delirium recognition and management in PICUs. Future studies should investigate the long-term effects of delirium education programmes on patient outcomes.

Implications for clinical practice: An integrated instructional approach was employed to improve nurses' knowledge, self-confidence, attitudes, and screening accuracy for delirium.