Comparison of barriers found by the first survey versus the results of the second survey
| Before | After | |
| (A) Attitudes and perceptions | %* | |
| Delirium occurrence and importance | ||
| Delirium is preventable | 21 | 15 |
| Screening | %* | |
| Is a nurse capable to identify delirium with a validated delirium screening instrument? | 34 | 80 |
| Collaboration | %* | |
| When I as nurse suspect a patient to be delirious, I am satisfied with delirium treatment | 47 | 40 |
| When I as physician suspect a patient to be delirious, the nurse is satisfied with delirium treatment | 42 | 11 |
| Collaboration between doctors and nurses with regard to delirium at the ICU can be improved by better screening | 65 | 30 |
| Collaboration between doctors and nurses with regard to delirium at the ICU can be improved by routinely addressing delirium in daily rounds | 74 | 78 |
| (B) Current practices | ||
| Delirium screening | %* | |
| In the ICU unit where I work the following delirium screening scale is in use: | ||
| CAM-ICU (Before: n=210; in only two hospitals / After: n=119) | 58 | 45 |
| ICDSC (before: n=3/after: n=104) | <1 | 39 |
| Delirium prevention | ||
| Earplugs for the night | 8 | 24 |
| Family visits as much as possible | 50 | 61 |
| (C) Guideline adherence (n=136) | ||
| If I follow the guideline recommendations, it is likely that my patients would not receive optimal care† | 3.1 (1.0) | 1.9 (1.1) |
| I do not wish to change my delirium care practices, regardless of what delirium guideline recommends† | 3.7 (1.0) | 1.4 (1.0) |
| I don’t have time to use this guideline† | 3.5 (0.9) | 1.7 (1.0) |
| This guideline is cumbersome and inconvenient† | 3.0 (1.1) | 2.0 (1.1) |
| (D) Guideline adherence in general (n=128) | ||
| Generally, guidelines are cumbersome and inconvenient† | 3.0 (0.9) | 2.2 (0.9) |
| Guidelines are difficult to apply and adopt to my specific practice† | 3.1 (0.9) | 2.0 (0.9) |
| Guidelines interfere with my professional autonomy† | 3.3 (0.9) | 1.7 (0.9) |
| Generally, I would prefer to continue my routines and habits rather than to change† based on practice guidelines† | 3.3 (1.0) | 1.9 (0.9) |
| I am not really expected to use guidelines in my practice setting† | 3.7 (0.9) | 1.4 (1.0) |
*= % agreement (= %YES answers or % of the sum of agree and strongly agree answers (from the 5-point Likert Scale statements)). Barriers depends on the question formulation. For positive formulated the barrier is ≤50% and negative formulated the barrier is ≥50%.
†= mean and SD based on the six-point Likert Scale. Mean score of ≥3 was considered to indicate agreement with statement=Barrier.
CAM-ICU, Confusion Assessment Method for the ICU; ICDSC, Intensive Care Delirium Screening Checklist; ICU, intensive care unit.