Date of Conferral

11-29-2024

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Margaret Harvey

Abstract

Patients experiencing delirium are challenging for nurses, especially when aggressive behavior is also present. Nurses from all specialties have the potential to encounter patients who have or develop delirium during their hospitalization, particularly in the intensive care unit. Nurses may lack the experience needed to recognize impending aggression which often presents as subtle cognitive changes or do not know the proper way to manage these types of patients. This makes standardized guidelines crucial for the safety of both the nurse and the patient. This project addresses that practice gap through developing an evidence-based clinical practice guideline (CPG) that will help nurses recognize and manage aggressive behavior in patients experiencing delirium. Evidence used for the development of the CPG was sourced from databases accessed through the Walden University library, including PUBMED, EBSCO, CINAHL, MEDLINE, and Google Scholar. Peer-reviewed, full-text articles published within the past five years were appraised using an evidence-based practice model. After completion, the CPG underwent rigorous evaluation through the Walden University Capstone Committe and was subsequently reviewed, by an expert panel, using the AGREE II tool. Following implementation within the chosen clinical site, guideline effectiveness was assessed through post-implementation questionnaire. Results demonstrated the CPG improved the nurse’s confidence in identifying and managing aggressive behavior in patients experiencing delirium in the ICU. This project underscores the importance of evidence-based interventions in bridging clinical practice gaps. The CPG offers a structured approach to enhance nursing competencies in aggression management, promoting patient and staff safety. Future efforts should focus on implementation of this CPG in other units within the same clinical setting. This CPG can also be modified to fit other healthcare clinical settings, as well as other customer-based industries.

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