Facilitators and Barriers for Nurses Implementing Delirium PADIS Guidelines in the Intensive Care Unit: An Integrative Review.
Background: Many barriers exist in the literature related to the implementation of the Clinical Practice Guidelines for the Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in the intensive care unit (ICU). Objectives: The objective of this integrative review was to ident...
| Publicado en: | Dimensions of Critical Care Nursing Vol. 44; no. 6; pp. 328 - 353 |
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| Autores principales: | , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Nov/Dec2025
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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=188357428&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188357428 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07304625 48N jtl: Dimensions of Critical Care Nursing issn: 07304625 maglogo: N pubinfo: dt: Nov/Dec2025 vid: 44 iid: 6 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 188357428 188357428 188357428 10.1097/DCC.0000000000000725 188357428 ppf: 328 ppct: 25 formats: tig: atl: Facilitators and Barriers for Nurses Implementing Delirium PADIS Guidelines in the Intensive Care Unit: An Integrative Review. aug: au: Thomas, Alyssa G. Davis, Suja P. affil: Alyssa G. Thomas, BSN, RN, is clinical nurse I, Neurosurgery ICU, UNC Health Care, Chapel Hill, North Carolina, since 2024. Alyssa provides care for critically ill adult patients, including those with complex neurological conditions and individuals recovering from neurosurgical procedures. sug: subj: Program Implementation Critical Care Nursing Practice Guidelines Intensive Care Units Delirium Prevention and Control Nurse Attitudes Nursing Practice Implementation Science Quality Improvement Human Systematic Review PubMed CINAHL Database Pain Management Sedation Sleep Disorders Interprofessional Relations Communication Checklists Support, Psychosocial Workload Delirium Education Health Education Nurses Education Nursing Knowledge ab: Background: Many barriers exist in the literature related to the implementation of the Clinical Practice Guidelines for the Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in the intensive care unit (ICU). Objectives: The objective of this integrative review was to identify barriers to and facilitators of nurses' PADIS delirium guideline implementation in adult ICU settings. Methods: We followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines as a framework for this review and the Joanna Briggs Institute quality appraisal guidelines. The inclusion criteria led to the identification of quantitative and qualitative studies, quality improvement projects, and review studies published in English between 2013 and 2023 that addressed adult ICU patients and explored facilitators and barriers regarding nurses' delirium guideline implementation in a variety of countries. Results: The 15 selected studies were 5 cross-sectional studies, 2 mixed-methods studies, 1 cohort report, 3 qualitative studies, 3 quality improvement projects, and 1 systematic review. The most commonly reported barriers concerned a lack of interdisciplinary collaboration and support, a workload burden, and knowledge deficits among nurses. The most commonly reported facilitators were related to interdisciplinary collaboration and education on delirium, PADIS guideline, and ABCDE bundle. Discussion: Delirium is crucial to address in critically ill patients, and nurses' implementation of PADIS guidelines is vital for better outcomes. This review identified barriers and facilitators at individual, educational, and institutional levels. The review findings emphasize the need for routine and structured education for nurses on delirium risk factors, prevalence, outcomes, complications, management, and assessment to combat the educational deficits that inhibit guideline implementation. The review findings also highlight the need for interdisciplinary collaboration and education to effectively support nurses. Hospitals and other institutions can leverage these insights to develop strategic interdisciplinary education planning, including delirium-focused rounds and routine interdisciplinary discussions about incorporating delirium guidelines into the care of ICU patients. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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