title: Managing delirium in the acute care setting: a pilot focus group study.
abstract: BACKGROUND
  Delirium frequently occurs in hospitalised older adults leading to poor outcomes and frequent adverse events. Proper recognition and management of delirium by acute care nurses can minimise the effects of negative sequelae associated with delirium.
  
  
  OBJECTIVE
  This pilot study used focus group methodology to: (i) describe acute care nurse's experience and knowledge regarding assessment and management of delirium in hospitalised older adults; (ii) illustrate potential facilitators and barriers to non-drug management of delirium; and (iii) to explicate the use of non-drug interventions by acute care nurses to manage delirium in hospitalised older adults.
  
  
  METHODS
  Qualitative, pilot study.
  
  
  METHODS
  A total of 16 nurse participants, working on medical, surgical and orthopaedic units from one acute care hospital participated in two focus groups.
  
  
  RESULTS
  Main themes included the following: confusion is normal; our duty is to protect; and finding a balance. Nurses were able to identify non-pharmacological interventions for delirium and facilitators and barriers to using these in clinical practice.
  
  
  CONCLUSIONS
  Findings from this pilot study illustrate the need for regular assessment of cognitive status in hospitalised older adults and nursing staff education regarding the use of non-pharmacological management of delirium. Based on their experience, nurses have a wealth of ideas for managing delirium. Areas for future research and policy are also highlighted.
  
  
  CONCLUSIONS
  More research is needed on how to improve delirium management by acute care nurses to increase the efficacy and use of non-pharmacological interventions in the management of delirium in hospitalised older adults. To translate these findings into practice, nursing care needs to be guided by evidence-based guidelines to implement non-pharmacological strategies in the acute care setting.
authors.affiliation: The Pennsylvania State University, School of Nursing, University Park, PA 16803, USA. amy139@psu.edu
authors.forename: Andrea
authors.initials: A
authors.lastname: Yevchak
authors.forename: Melinda
authors.initials: M
authors.lastname: Steis
authors.forename: Theresa
authors.initials: T
authors.lastname: Diehl
authors.forename: Nikki
authors.initials: N
authors.lastname: Hill
authors.forename: Ann
authors.initials: A
authors.lastname: Kolanowski
authors.forename: Donna
authors.initials: D
authors.lastname: Fick
mesh_terms: D000208:Acute Disease / Q000451:nursing; D000368:Aged; D002983:Clinical Competence / Q000706:statistics & numerical data; D003693:Delirium / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D017144:Focus Groups; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods*; D015399:Nursing Research; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D010414:Pennsylvania; D010865:Pilot Projects; D018794:Problem-Based Learning; D036301:Qualitative Research; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D017748:Time Management; D016896:Treatment Outcome