Delirium in the ICU is often under diagnosed, mainly when occurring to mechanically ventilated patients, especially if manifested as sub syndromal delirium. Aim: To evaluate the general knowledge on delirium of the personnel caring for critically ill patients in an academic ICU, both medical and surgical, provided with 11 specialists, 15 residents and 40 nurses for a total number of 35 beds.
A survey questionnaire was addressed to the ICU nurses and doctors, stratified as residents and specialists. Two MCQ questions explored the incidence of delirium in the ICU and the context it occurred, while the 3rd question was referring to a fluctuating level of consciousness self-experienced while working. The questionnaires were blinded as to the identity of the responders, but their age, gender, profession and experience in the ICU were noted. All the doctors responded, and only 22 nurses. A previous assessment of the same personnel showed signs of burn-out syndrome to 2 nurses.
Delirium was recognized easily by nurses, who often and wrongly attributed it to alcohol withdrawal syndrome, and were prone to use physical restraints. The doctors’ attitude was different in terms of diagnosing the etiology of delirium and preferring medication to physical restraints. As to admitting to have recognized to oneself while in charge signs of fluctuating level of consciousness, confusion or disorganized thinking, the only ones to admit it were a few number of nurses (3 out of 22) who attributed it to overloading activity, psychological stress and exhaustion.Comments were focused on union rights and less on the topic explored.
1. General knowledge on delirium is under the acceptable level and there for CME requires an upgrade on the topic.2. We need to insert in the patients’ files the CAM-ICU scale. 3. The significant differences in the attitude of the doctors and nurses in managing delirium to the critically ill have to be harmonized.
Different attitudes may lead to conflicts in the ICU.
Sanda-Maria Copotoiu, No Financial Disclosure Information; No Product/Research Disclosure Information