[Estudio cuasi-experimental sobre intervenciones enfermeras en la valoración, manejo y prevención del síndrome confusional agudo.] / Quasi-experimental study on nursing interventions in the assessment, management and prevention of acute confusional syndrome.

OBJECTIVE: Acute confusional syndrome (ACS) is one of the complications with the highest morbidity and mortality in hospitalization units, but it is a reversible situation if detected early, representing a clear challenge for nursing. The objectives of this study were to assess the interventions carried out by nurses for the identification and non-pharmacological preventive measures applied in acute confusional syndrome and relate them to the years of professional experience and training received. METHODS: A quasi-experimental, prospective and analytical study was carried out through a self-administered structured questionnaire pre-post intervention (extracted from the JBI PACES program-Practical Application of Clinical Evidence System) on the identification and preventive measures applied in ACS. A total of 520 questionnaires (pre and post assessment) were distributed to nurses from the emergency department and the internal medicine unit of the Miguel Servet University Hospital in Zaragoza (Aragón, Spain) from January 2021 to April 2022. Statistical analysis carried out with the program Jamovi®2.3.13. RESULTS: 180 correctly completed questionnaires (94 pre and 86 post) were received. For 100%, the ACS supposed an extra workload and significant differences were found between the ability to manage ACS with the years of professional experience (p≤0.028). 97.2% of the nurses applied non-pharmacological interventions. CONCLUSIONS: Despite being perceived as an extra burden in daily work, nurses perform non-pharmacological prevention for the management of ACS. It is necessary to improve training to provide guidance strategies.

OBJETIVO: El síndrome confusional agudo (SCA) es una de las complicaciones con mayor morbimortalidad en las unidades de hospitalización, pero es una situación reversible si se detecta a tiempo, representando un claro desafío para la enfermería. Los objetivos de este estudio fueron valorar previa y posteriormente las intervenciones realizadas por las enfermeras para la identificación y la adopción de las medidas preventivas no farmacológicas aplicadas en el síndrome confusional agudo, así como relacionarlas con los años de experiencia profesional y la formación recibida. METODOS: Se realizó un estudio cuasi experimental, prospectivo y analítico a través de cuestionario estructurado autoadministrado pre-post intervención (extraído de la JBI PACES program-Practical Application of Clinical Evidence System) sobre la identificación y las medidas preventivas aplicadas en el SCA. Se distribuyeron un total de quinientos veinte cuestionarios (valoración pre y post) a enfermeras del servicio de Urgencias y la unidad de medicina interna del Hospital Universitario Miguel Servet de Zaragoza (Aragón, España) de enero de 2021 a abril de 2022. El análisis estadístico se realizó con el programa Jamovi® 2.3.13. RESULTADOS: Se recibieron ciento ochenta cuestionarios cumplimentados correctamente (noventa y cuatro pre y ochenta y seis post). Para el 100%, el SCA supuso una carga de trabajo extra y se hallaron diferencias estadísticamente significativas entre la capacidad de manejo de SCA con los años de experiencia profesional (p≤0,028). El 97,2% de las enfermeras aplicaron intervenciones no farmacológicas. CONCLUSIONES: A pesar de percibirse como una carga extra en el trabajo diario, las enfermeras realizan prevenciones no farmacológicas para el manejo del SCA. Es necesario mejorar la formación para proporcionar estrategias de orientación.

Delirium risk screening and assessment among older patients in general wards and the emergency department: a best practice implementation project.

OBJECTIVES: The aim of this project was to improve compliance with evidence-based criteria regarding risk of delirium and the assessment of delirium among older patients in the general hospitalization wards and the emergency department. INTRODUCTION: More than 50% of older hospitalized patients experience delirium. Some studies have highlighted the need to implement an orientation protocol in the emergency department and to continue this in the general wards, with the aim of decreasing the delirium rate among older patients admitted to hospital. METHODS: The project followed the JBI evidence implementation framework. We conducted a baseline audit, a half-way audit, and final audit of 50 patients at risk of delirium admitted to the emergency department and the general wards, respectively. The audits measured compliance with eight criteria informed by the available evidence. RESULTS: In the final audit, three of the eight criteria achieved more than 50% compliance in the general wards: pressure injury screening (96%); monitoring changes (74%); and performing interventions (76%). In the emergency department, worse results were reported because of the service conditions. The exception was the criterion on the training of nurses on the topic, with 98%. The integration of a tool to screen for delirium in older patients in the hospital's electronic clinical history records increased the percentage of compliance with audit criteria regarding the use of the scale and delirium detection (rising from 0% to 32% in the final audit in the general wards). CONCLUSION: Through the implementation of this project, validated and evidence-based evaluation will ensure that nurses are supported through appropriate measures to reduce patient confusion and aggression resulting from delirium.

Estudio cuasi-experimental sobre intervenciones enfermeras en la valoración, manejo y prevención del síndrome confusional agudo / Quasi-experimental study on nursing interventions in the assessment, management and prevention of acute confusional syndrome

Fundamentos: El síndrome confusional agudo (SCA) es una de las complicaciones con mayor morbimortalidad en las unidades de hospitalización, pero es una situación reversible si se detecta a tiempo, representando un claro desafío para la enfermería. Los objetivos de este estudio fueron valorar previa y posteriormente las intervenciones realizadas por las enfermeras para la identificación y la adopción de las medidas preventivas no farmacológicas aplicadas en el síndrome confusional agudo, así como relacionarlas con los años de experiencia profesional y la formación recibida. Métodos: Se realizó un estudio cuasi experimental, prospectivo y analítico a través de cuestionario estructurado autoadministrado pre-post intervención (extraído de la JBI PACES program-Practical Application of Clinical Evidence System) sobre la identificación y las medidas preventivas aplicadas en el SCA. Se distribuyeron un total de quinientos veinte cuestionarios (valoración pre y post) a enfermeras del servicio de Urgencias y la unidad de medicina interna del Hospital Universitario Miguel Servet de Zaragoza (Aragón, España) de enero de 2021 a abril de 2022. El análisis estadístico se realizó con el programaJamovi® 2.3.13. Resultados: Se recibieron ciento ochenta cuestionarios cumplimentados correctamente (noventa y cuatro pre y ochenta y seis post). Para el 100%, el SCA supuso una carga de trabajo extra y se hallaron diferencias estadísticamente significativas entre la capacidad de manejo de SCA con los años de experiencia profesional (p=<0,028). El 97,2% de las enfermeras aplicaron intervenciones no farmacológicas. Conclusiones: A pesar de percibirse como una carga extra en el trabajo diario, las enfermeras realizan prevenciones no farmacológicas para el manejo del SCA. Es necesario mejorar la formación para proporcionar estrategias de orientación.(AU)

Background: Acute confusional syndrome (ACS) is one of the complications with the highest morbidity and mortality in hospitalization units, but it is a reversible situation if detected early, representing a clear challenge for nursing. The objectives of this studywere to assess the interventions carried out by nurses for the identification and non-pharmacological preventive measures applied inacute confusional syndrome and relate them to the years of professional experience and training received.Methods: A quasi-experimental, prospective and analytical study was carried out through a selfdministered structured questionnaire pre-post intervention (extracted from theJBI PACES program-Practical Application of Clinical Evidence System) on the identificationand preventive measures applied in ACS. A total of 520 questionnaires (pre and post assessment) were distributed to nurses from theemergency department and the internal medicine unit of the Miguel Servet University Hospital in Zaragoza (Aragón, Spain) from January2021 to April 2022. Statistical analysis carried out with the programJamovi®2.3.13.Results: 180 correctly completed questionnaires (94 pre and 86 post) were received. For 100%, the ACS supposed an extra workload and significant differences were found between the ability to manage ACS with the years of professional experience (p=<0.028).97.2% of the nurses applied non-pharmacological interventions.Conclusions: Despite being perceived as an extra burden in daily work, nurses perform nonpharmacological prevention for themanagement of ACS. It is necessary to improve training to provide guidance strategies.(AU)