Nurses’ experiences of caring for older patients with delirium in the surgical setting

Abstract

PURPOSE AND BACKGROUND: Delirium is a prevalent complication among older patients. It affects a large proportion of adult patients in the surgical setting (Barr et al., 2013). Moreover, Malta’s ageing population will very probably bring about an increased prevalence of delirium across the healthcare setting. Delirium has been linked to increased morbidity and mortality, long-term cognitive impairments, psychological distress, extended hospital stays, and increased hospital and health system costs. Nurses play central roles in the care of surgical older patients who are afflicted with this debilitating disease. This study aims to explore surgical nurses’ experiences of caring for older patients with delirium, what facilitates and what hinders surgical nurses’ caring for such patients, and provide concrete recommendations for further care of these patients.

METHOD: A qualitative descriptive design was employed for the study. Thematic analysis developed by Clarke and Braun (2006) was selected as the method for data analysis to facilitate and lead this process. Accordingly, this technique recognises, evaluates and explains patterns of significance, known as ‘themes’ in qualitative data (Clarke & Braun, 2017). A total of eight participants, who work in a surgical setting at the local general hospital, were recruited by an intermediary to voluntarily participate in the study. Qualitative, semi-structured individual interviews were conducted, after all ethical clearance and permissions were granted.

RESULTS: Four themes emerged from the data, namely: a. hardships in providing optimal surgical care; b. importance of prioritizing the safety of patients and others; c. the relevance of including relatives in patient care; and d. the usefulness of focusing on nurses’ experience when caring for these patients.

CONCLUSIONS: Surgical nurses find a way to keep the patients and others safe and help their families throughout this challenging and distressing experience. Nurses require a greater support and understanding of the management and physicians especially during night shifts. A variety of proposals might help to ease the experience of surgical nurses when caring for older patients with delirium that if successful may well have positive impacts on the healthcare system.