Korean J Adult Nurs.  2023 Nov;35(4):379-392. 10.7475/kjan.2023.35.4.379.

Performance, Knowledge, and Barrier Awareness of Medical Staff Regarding the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Critical Care Patients: A Cross-Sectional Study

• Song HG
• Chae D
• Yoo SH

• KMID: 2548973
• DOI: http://doi.org/10.7475/kjan.2023.35.4.379

Abstract

Purpose
This study investigated the knowledge, performance, and barrier awareness of Intensive Care Unit (ICU) medical staff concerning the prevention and management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in critically ill adult patients, and aimed to identify the factors influencing the performance of evidence-based PADIS management.
Methods
This cross-sectional and correlational study included 189 medical staff (17 physicians, 172 nurses) working in ICUs in two hospitals and recruited between July 13 and 31, 2022. Multiple linear regression analysis was performed to identify the factors associated with the PADIS-related performance of medical staff.
Results
The evidence-based performance level for PADIS prevention and management had a mean score of 3.55±0.37 out of 5 points, and the mean knowledge score was 28.23±3.00 out of 33 points. The mean awareness score for barriers to implementing PADIS prevention and management guidelines was 2.91±0.39 out of 5 points. Multiple regression analysis indicated that knowledge of delirium (β=.19, p=.014) and awareness of barriers within the individual domains of medical staff (β=-.20, p=.034) significantly influenced PADIS-related performance.
Conclusion
To implement evidence-based practices for the prevention and management of PADIS, steps should be taken to improve the knowledge and awareness of medical staff regarding PADIS. This could be improved through organizational support, such as systematic education and staffing. Specifically, an education program centered on delirium could significantly improve PADIS-related knowledge and performance.

Keyword

Delirium; Immobilization; Pain; Psychomotor agitation; Sleep