title: Attitudes, knowledge and practices concerning delirium: a survey among intensive care unit professionals.
abstract: Delirium is a common form of vital organ dysfunction in intensive care unit (ICU) patients and is associated with poor outcomes. Adherence to guideline recommendations pertaining to delirium is still suboptimal.
  
  
  
  We performed a survey aimed at identifying barriers for implementation that should be addressed in a tailored implementation intervention targeted at improved ICU delirium guideline adherence.
  
  
  
  The survey was conducted among ICU professionals.
  
  
  
  An online survey was conducted among 360 ICU health care professionals (nurses, physicians and delirium consultants) from six ICUs in the southwest of the Netherlands as part of a multicentre prospective implementation project [response rate: 64% of 565 invited; 283 (79%) were nurses].
  
  
  
  Although the majority (83%) of respondents considered delirium a common and major problem in the ICU, we identified several barriers for implementation of a delirium guideline. The most important barriers were knowledge deficit, low delirium screening rate, lack of trust in the reliability of delirium screening tools, belief that delirium is not preventable, low familiarity with delirium guidelines, low satisfaction with physician-described delirium management, poor collaboration between nurses and physicians, reluctance to change delirium care practices, lack of time, disbelief that patients would receive optimal care when adhering to the guideline and the perception that the delirium guideline is cumbersome or inconvenient in daily practice.
  
  
  
  Although ICU professionals consider delirium a serious problem, several important barriers to adhere to guidelines on delirium management are still present today.
  
  
  
  Identification of implementation barriers for adherence to guidelines pertaining to delirium is feasible with a survey. Results of this study may help to design-targeted implementation strategies for ICU delirium management.
authors.affiliation: Department of Intensive Care, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Trogrlić
authors.affiliation: Department of Pediatric Surgery, Intensive Care Unit, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: Ista
authors.affiliation: Department of Intensive Care, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: Huibert H
authors.initials: HH
authors.lastname: Ponssen
authors.affiliation: Department of Intensive Care, Ikazia Hospital, Rotterdam, the Netherlands.
authors.forename: Jeannette F
authors.initials: JF
authors.lastname: Schoonderbeek
authors.affiliation: Department of Intensive Care, IJsselland Hospital, Rotterdam, the Netherlands.
authors.forename: Frodo
authors.initials: F
authors.lastname: Schreiner
authors.affiliation: Department of Intensive Care, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Serge J
authors.initials: SJ
authors.lastname: Verbrugge
authors.affiliation: Department of Intensive Care, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Dijkstra
authors.affiliation: Department of Intensive Care, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Bakker
authors.affiliation: Department of Intensive Care, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Mathieu
authors.initials: M
authors.lastname: van der Jagt
mesh_terms: D002983:Clinical Competence; D003422:Critical Care / Q000458:organization & administration; D064648:Critical Care Nursing / Q000379:methods*; D003693:Delirium / Q000451:nursing*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Attitude; Delirium; Guideline; Implementation; Intensive Care Units; Knowledge