Perceptions and Practices of Clinicians Undertaking Invasive Procedures With Patients Experiencing Delirium in Hospital: A Sequential Mixed Methods Study.
Amanda Fox, Sandra Johnston, Katy Wyles and 5 others
PMID 40442059WHAT IT FOUND
Clinicians reported planning, knowing the patient, calm simple communication, distraction, and postponement.
Restraint was a last resort. In 24 observed procedures, 7 patients were distressed and 2 were abandoned.
Key findings
01Twenty-one procedures were completed.
02Seven patients were distressed at the start of procedures, two procedures were abandoned, and physical restraint was used once.
03Observed clinician actions were grouped into valuing the patient and building trust, engaging to progress, and physical restraint as a last resort.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was small and took place in a single specialist dementia care ward, so it may not reflect other hospital wards or patients without delirium. Patients and clinicians were convenience samples, and clinicians chose to take part, so practices of non-participants are unknown. COVID-19 restrictions meant no visitors or family were present, and all clinicians wore masks, which may have changed patient distress and clinician communication. The study did not compare approaches, so it cannot show that any strategy reduced distress or improved completion. Restraint and sedation frequency came partly from clinician reports and varied, and only one restraint event was observed.
Declared interests
One author declared monies received by her employer from BD Medical and ITL Biomedical for educational consultancies unrelated to this research. All other authors declared no conflicts.
The easy way to misread this
Do not read these strategies as proven to reduce distress. The study observed 24 procedures in a single ward and had no comparison group, so it reports what clinicians did, not what worked.