Data from: How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups.

Objectives: The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the ICU and to describe the process of delirium management. Setting: This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain). Participants: Purposeful sampling was performed which included a) doctors and nurses working in ICUs b) with > 1 year experience in the ICU, and c) clinical experience with delirium. Thirty-eight professionals participated (19 doctors, 19 nurses), including 22 women and 16 men. The total mean age was 39 years. Design: A qualitative study using focus groups. Methods: Seven focus groups were held to collect data: 3 nurse focus groups, 3 doctor focus groups and one mixed focus group. Each group comprised 6-10 participants. A semi-structured questions guide was used. Thematic analysis methods were used to analyze the data. Results: Three themes were identified: a) The professional perspective on delirium; b) Implementing pharmacological and non-pharmacological treatment for delirium and c) Work organization in the ICU. The professionals regarded patients with delirium with uncertainty, and felt they were often underdiagnosed and poorly managed. Doctors displayed discrepancies regarding pharmacological prescriptions and decision-making. The choice of medication was determined by experience. Nurses felt that, for many doctors, delirium was not considered a matter of urgency in the ICU. Nurses encountered difficulties when applying verbal restraint, managing sleep disorders and providing early mobilization. The lack of a delirium protocol generates conflicts regarding what type of care management to apply, especially during the night shift. A degree of group pressure exists which, in turn, influences the decision-making process and patient care. Conclusions: Patients with delirium represent complex cases, requiring the implementation of specific protocols. These results serve to improve the process of care in patients with delirium.