Education for Recognition and Management of Delirium

Study Overview
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Brief Summary
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Delirium is a disturbance in consciousness with reduced ability to focus, sustain, or shift attention that occurs over a short period of time and tends to fluctuate over the course of the day. 50% to 81.7% had delirium during their ICU hospitalization. Delirium is associated with increased physical restraint, ventilation use, length of ICU stay, and mortality. However, there is no established delirium care pathway in target hospital. Chen et al. (2014) demonstrated that structured assessment stations with immediate feedback may improve overall learning efficiency over an EBP workshop alone. However, no published delirium care education study has used OSCEs as an intervention for healthcare professionals. The aim is to evaluate the effects of implementing a Scenario-based education intervention, including objective structured clinical examinations (OSCEs) on delirium care among healthcare professionals. This is a knowledge translation research, builds on eight years of delirium care research in University of Wollongong, Australia. The research will be undertaken at ICUs in a medical center in northern of Taiwan. There are two phases: (1) systematic review to identify delirium screen tool, and (2) a randomized controlled trial was conducted to determine the effects of implementing a Scenario-based education intervention, including OSCE (experimental group), and on-line education only (control group) focused on recognition and management of delirium. The hypothesis is: Scenario-based education intervention, including OSCE can increase the competence and self-efficacy among healthcare professionals in delirium care.

Detailed Description
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OSCEs are an integral aspect of all levels of medical education but limited to undergraduate nursing and allied health education. OSCEs are rarely used in the workplace as learning activities with nursing and allied health clinicians. This is the reason why this education initiative was innovative. OSCEs are simulated 'real life' clinical scenarios presented to clinicians who are required to demonstrate to an assessor the clinical tasks which form an OSCE scenario.

Official Title
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Evaluating the Effects of Implementing an Scenario-based Education Initiative and OSCE for Recognition and Management of Delirium in Adult Intensive Care Unit: Randomised Controlled Trial

Conditions
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Delirium, Intensive Care Unit Syndrome, Nurse-Patient Relations

Intervention / Treatment
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* Behavioral: OSCEs
* Behavioral: Lecture
* Behavioral: E-learning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Registered nurse worked in acute care unit and care with critical patients Age > 20 years old. Exclusion Criteria: Unwilling to involved the research

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: experimental group<br>face-to-face delirium care session (30 minutes in duration); online learning delirium care activities (20 minutes in duration); and delirium care OSCE and reflective activity (30 minutes in duration). | Behavioral: OSCEs<br>* Scenario-based education intervention, including objective structured clinical examinations (OSCEs)<br>Behavioral: Lecture<br>* Face-to-face Education using Delirium Care Flip Chart<br>Behavioral: E-learning<br>* delirium care video<br>|
| Active Comparator: control group<br>face-to-face delirium care session (30 minutes in duration); online learning delirium care activities (20 minutes in duration) | Behavioral: Lecture<br>* Face-to-face Education using Delirium Care Flip Chart<br>Behavioral: E-learning<br>* delirium care video<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Delirium Knowledge and Skills at the time Immediately after the intervention and Six weeks | Delirium Knowledge and Skills Test (included 18 questions) | T0(Baseline), T1(Immediately after the intervention), T2(Six weeks after the intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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delirium, knowledge translation, Objective Structured Clinical Examination, evidence-based practice