title: Intensive care nurses' experiences and perceptions of delirium and delirium care.
abstract: OBJECTIVE
  To explore nurses' experiences and perceptions of delirium, managing delirious patients, and screening for delirium, five years after introduction of the Confusion Assessment Method for Intensive Care into standard practice.
  
  
  METHODS
  Twelve nurses from a medical-surgical intensive care unit in a large teaching hospital attended two focus group sessions. The collected qualitative data was thematically analysed using Braun and Clarke's framework (2006).
  
  
  RESULTS
  The analysis identified seven themes: (1) Delirium as a Secondary Matter (2) Unpleasant Nature of Delirium (3) Scepticism About Delirium Assessment (4) Distrust in Delirium Management (5) Value of Communication (6) Non-pharmacological Therapy (7) Need for Reviewed Delirium Policy.
  
  
  CONCLUSIONS
  Nurses described perceiving delirium as a low priority matter and linked it to work culture within the intensive care specialty. Simultaneously, they expressed their readiness to challenge this culture and to promote the notion of providing high-quality delirium care. Nurses discussed their frustrations related to lack of confidence in assessing delirium, as well as lack of effective therapies in managing this group of patients. They declared their appreciation for non-pharmacological interventions in treatment of delirium, suggested improvements to current delirium approach and proposed introducing psychological support for nurses dealing with delirious patients.
authors.affiliation: Cambridge University Hospitals, Addenbrooke's Hospital, Intensive Care Unit, Hills Road, Cambridge, CB2 OQQ Cambridgeshire, UK. Electronic address: kate.zamoscik@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zamoscik
authors.affiliation: University of Hertfordshire, Department of Adult Nursing and Primary Care, School of Health and Social Work, Room 2F287 (Wright Building), College Lane, Hatfield, AL10 9AB Hertfordshire, UK. Electronic address: r.godbold@herts.ac.uk.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Godbold
authors.affiliation: University of Hertfordshire, Department of Adult Nursing and Primary Care, School of Health and Social Work, Room 2F279 (Wright Building), College Lane, Hatfield, AL10 9AB Hertfordshire, UK. Electronic address: p.freeman@herts.ac.uk.
authors.forename: Pauline
authors.initials: P
authors.lastname: Freeman
mesh_terms: D064648:Critical Care Nursing / Q000379:methods; D003693:Delirium / Q000451:nursing*; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D009726:Nurses / Q000523:psychology* / Q000592:standards; D009732:Nursing Care / Q000523:psychology; D010465:Perception; D036301:Qualitative Research; D000078329:Workforce
keywords: CAM-ICU; Delirium; Delirium care; Nurse experience; Qualitative research