Effect of educational training about CAM-ICU on nurses' knowledge, confidence, and practice to detect delirium among critically ill patients in intensive care unit.

BACKGROUND

Delirium in the intensive care unit (ICU) is a serious complication associated with increased mortality, prolonged hospital stays, and long-term cognitive decline. Early detection through standardized assessment tools is critical to improving patient outcomes. This study evaluated the effect of an educational training program on ICU nurses' self-reported knowledge, perceived self-confidence, and comfort levels in using the Confusion Assessment Method for the ICU (CAM-ICU), as well as their observed performance in delirium assessment and documentation.

METHODS

A quasi-experimental single-group pretest-posttest design was conducted with 50 ICU nurses in an Egyptian ICU. Participants received a four-week educational program on delirium and CAM-ICU use. Knowledge, confidence, and comfort levels were measured before and after training using validated questionnaires. Post-training performance was assessed using an observational checklist evaluating assessment accuracy, documentation completeness, and consistency. Paired t-test was used for data analysis.

RESULTS

ICU nurses' knowledge and confidence in using the CAM-ICU significantly improved after training (p < .001). Post-training, assessment accuracy (95.5%) and documentation completeness (91.3%) were high, while practice consistency (79%) met the satisfactory threshold (≥ 75%), indicating satisfactory performance in delirium assessment and documentation using CAM-ICU.

CONCLUSIONS

The educational training significantly improved ICU nurses' knowledge, perceived self-confidence, comfort levels, and practical skills in delirium assessment using the CAM-ICU, leading to more accurate and consistent screening practices. Structured, interactive training should be integrated into ICU education to promote standardized delirium assessment in ICU settings.

IMPLICATIONS FOR PRACTICE: Integrating structured delirium education into ICU training can promote adherence to best practices, ensuring timely detection and intervention. Future research should examine long-term skill retention and its effect on patient outcomes.

CLINICAL TRIAL NUMBER: Not applicable.