Clinicians' delirium treatment practice, practice change, and influences: A national online survey.
Background: Recent studies cast doubt on the net effect of antipsychotics for delirium. Aim: To investigate the influence of these studies and other factors on clinicians' delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework...
| Publicado en: | Palliative Medicine Vol. 35; no. 8; pp. 1553 - 1564 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Sep2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152489257&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 152489257 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02692163 31I jtl: Palliative Medicine issn: 02692163 maglogo: Y pubinfo: dt: Sep2021 vid: 35 iid: 8 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 152489257 150781308 152489257 152489257 10.1177/02692163211022183 152489257 ppf: 1553 ppct: 11 formats: tig: atl: Clinicians' delirium treatment practice, practice change, and influences: A national online survey. aug: au: Hosie, Annmarie Agar, Meera Caplan, Gideon A Draper, Brian Hedger, Stephen Rowett, Debra Tuffin, Penny Cheah, Seong Leang Phillips, Jane L Brown, Linda Sidhu, Manraaj Currow, David C affil: The University of Notre Dame Australia, School of Nursing and Midwifery, Darlinghurst, NSW, Australia sug: subj: Delirium Drug Therapy Palliative Care Conceptual Framework Professional Practice Behavioral Changes Antipsychotic Agents Therapeutic Use Surveys Implementation Science Antipsychotic Agents Psychological Distress Structured Questionnaires Open-Ended Questionnaires Australia Health Behavior Emotions Drugs, Off-Label Antianxiety Agents, Benzodiazepine Human Descriptive Statistics Confidence Intervals Odds Ratio ab: Background: Recent studies cast doubt on the net effect of antipsychotics for delirium. Aim: To investigate the influence of these studies and other factors on clinicians' delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework. Design: Australia-wide online survey of relevant clinicians. Setting/participants: Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals' organisations. Results: Most of the sample (n = 475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium at least weekly (61%). More (59%) reported delirium practice change since 2016, mostly by increased non-pharmacological interventions (53%). Fifty-five percent reported current antipsychotic use for delirium, primarily for patient distress (79%) and unsafe behaviour (67%). Common Theoretical Domains Framework categories of influences on respondents' delirium practice were: emotion (54%); knowledge (53%) and physical (43%) and social (21%) opportunities. Palliative care respondents more often reported: awareness of any named key study of antipsychotics for delirium (73% vs 39%, p < 0.001); changed delirium treatment (73% vs 53%, p = 0.017); decreased pharmacological interventions (60% vs 15%, p < 0.001); off-label medication use (86% vs 51%, p < 0.001: antipsychotics 79% vs 44%, p < 0.001; benzodiazepines 61% vs 26%, p < 0.001) and emotion as an influence (82% vs 39%, p < 0.001). Conclusion: Clinicians' use of antipsychotic during delirium remains common and is primarily motivated by distress and safety concerns for the patient and others nearby. Supporting clinicians to achieve evidence-based delirium practice requires further work. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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