ABSTRACT
Delirium is a kind of fluctuating cognitive impairment that occurs during a short time. Early detection of delirium leads to acceleration the treatment. There are many tools for identifyingand screening of delirium. This study aimed at comparing the advantages and disadvantages of the various tools used for diagnosing delirium, their validity and accuracy and the way they are used by physicians or nurses. In this review article, available databases including Pubmed, Medline, Science Direct, ProQuest, SID, Google Scholar was assayed by keywords such as delirium assessment, delirium tools, cognitive disorder and nurse, nurse and delirium. Among the 55 articles found from 1990 to 2012, 15 relevant articles included the study. A review of the related studies showed that the most common screening tools for delirium, which can be used by different person, were CAM, CAM-ICU, NeeCham, ICDSC, DSI, CTD, DOS, Nu-DESC. Each of these tools enjoys different levels of validity and reliability and can be used in different patients. Related articles in relation to diagnosis of delirium in nursing practice were limited. However, two questionnaires namely CAM-ICU and NeeCham were found to be more applicable for critically ill patients and enjoy a higher sensitivity and specificity with regard to other tools. Findings indicated that NeeCham questionnaire can be easily used by the nurses on the patient's bedside during daily activities and can even detect the susceptible patients sooner
ABSTRACT
Competency is a complicated and an ambiguous concept. It is also a challenging subject in the health care arena, which is significant in different aspects of nursing, such as education, clinic and management. There are ambiguities about it, thus, in this article, researchers conducted analysis of this concept. This research is a concept analysis by the hybrid method. This model has three steps. In literature review stage, 475 related articles exist in databases up to September 2007 were analyzed and evaluated. As to the importance of educational system in the training of nursing courses, 5 educators were interviewed in the field work stage. After listening to tapes, results were Tran scripted and content analysis was done. In the last stage, holistic analysis was carried out. Best definition and properties of competency was selected based on literature reviews. In the field work stage, categories and attributes, same as literature reviews stage, were emerged with interviewing of nursing educators, in addition to holistic view properties, in relation to attitude domain and creativity of management domain. In the last stage, a hybrid model was delivered. In the Iranian field of nursing, educational planning, implementing competency instrument, nurses and students evaluation can be performed according to this study criterion