Kimberly Liss, DNP, MS, CRNA

Abstract:

Background: Emergence delirium is an adverse reaction when awakening from anesthesia, defined as an abnormal mental state of restlessness, confusion, and possible combativeness. Emergence delirium occurs in approximately 5% of the general population, but it is more common and problematic in patients with a history of Post-Traumatic Stress Disorder (PTSD). Emergence delirium can lead to significant patient and staff injury and adverse patient outcomes, but many perioperative nurses lack training in best practices for the management of emergence delirium. Objectives To educate perioperative nurses on the identification and management of emergence delirium among patients with post-traumatic stress disorder (PTSD). Methods Perioperative nurses at three healthcare institutions were invited to participate in a 60-minute education intervention, including a simulation, to introduce evidence-based practices when caring for patients diagnosed with PTSD who experience emergence delirium. Participants completed a knowledge assessment and a self-reported confidence measure collected via Qualtrics electronic survey before and after the educational intervention and six weeks post-intervention. Bivariate tests were used to assess pre/post change in learning outcomes, and repeated measures ANOVA was used to examine retention of learning over time. Results Perioperative nurse participants (n= 36) at three hospitals participated in the intervention. Participants were predominantly women (81.8%) whose ages ranged from 18 to 64 years. Perioperative nurses most commonly worked in peri-anesthesia settings. Nurses who participated in the intervention demonstrated a pre/posttest increase in knowledge levels from 65.2% to 89.1% (p<.001) and confidence levels from 6.07 to 8.09 on a 10-point scale (p<.001), respectively. Knowledge and confidence gains were sustained at a six-week follow-up. Conclusion A brief educational intervention can raise nurses' awareness of the serious complication of emergence delirium and high-risk populations and increase their knowledge and confidence levels when caring for this patient population. KEY WORDS: Posttraumatic Stress Disorder, PTSD, Emergence Delirium, Evidence-Based Practices, Perioperative Nurses, Education

Click here to see the full manuscript.