ICU Delirium Playbook Training Study for ICU Nurses

NCT07759310 | Recruiting

• 1 other identifier: ICU_Delirium_PlayBook@IT_2026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Delirium is a common and serious acute neurocognitive disorder among critically ill patients, affecting up to 50% of intensive care unit (ICU) patients and up to 80-90% of those receiving invasive mechanical ventilation. It is associated with increased mortality, prolonged ICU and hospital length of stay, long-term cognitive impairment, higher healthcare costs, and reduced quality of life for patients and their families. Despite the availability of validated screening tools such as the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), delirium remains underrecognized and undertreated in routine clinical practice, largely because of inadequate healthcare professional education and inconsistent implementation of evidence-based recommendations. Nurses play a central role in the prevention, early detection, and management of delirium, making targeted educational interventions essential to improve clinical practice. The ICU Delirium Playbook is a multimedia educational program developed by the University of California, San Diego, consisting of brief instructional videos and realistic clinical scenarios designed to improve nurses' knowledge and confidence in delirium assessment and management. The aim of this quasi-experimental pre-post study is to evaluate the effectiveness of the ICU Delirium Playbook among intensive care nurses at Pisa University Hospital. The primary objective is to determine whether participation in the educational program improves nurses' knowledge of delirium. Secondary objectives are to evaluate participants' satisfaction with the training, assess changes in clinical attitudes and behaviors related to delirium care, validate the Italian version of the behavioral assessment questionnaire, and explore the impact of the educational intervention on patient outcomes, including the frequency of delirium recognition and the duration of delirium episodes. The study will be conducted in a single center using a pre-intervention and post-intervention design. Before the educational intervention, participating nurses will complete questionnaires evaluating delirium knowledge, attitudes, and clinical behaviors. During the same period, retrospective and prospective clinical data will be collected from medical records of adult patients admitted to the Cardio-Thoracic-Vascular Intensive Care Unit, including delirium assessment and diagnosis. Following baseline data collection, nurses will attend the ICU Delirium Playbook educational session, lasting approximately four hours. After completion of the videos, nurses will repeat the same questionnaires, and patient clinical data will be collected again during a six-month post-intervention period. The study is based on Kirkpatrick's Four-Level Model for training evaluation, assessing participants' reaction to the educational intervention, learning outcomes, behavioral changes in clinical practice, and the effects on patient care. It is expected that the intervention will improve nurses' knowledge and evidence-based management of delirium, increase the recognition of delirium in ICU patients. The findings of this study will provide evidence regarding the effectiveness of the ICU Delirium Playbook in the Italian critical care setting and may support the implementation of standardized delirium education programs in intensive care units.

Conditions

Nursing Education; Delirium Confusional State; ICU

Keywords

Delirium; Intensive Care Unit; Nursing Education; CAM-ICU

Outcome Measures

Primary Outcomes (1)

• Knowledge acquisition related to Delirium managment

  Delirium knowledge will be measured using the ICU Delirium Playbook Quiz, a 44-item multiple-choice questionnaire assessing nurses' knowledge of delirium prevention, recognition, assessment, and management. The score will be calculated as the number of correct answers, with a possible range from 0 to 44 points. The outcome will be reported as the change in total knowledge score from baseline (pre-training) to immediately after the training intervention.

  Pre-intervention (T0), Immediately post-intervention (T1), and at 6 months (T2)

Secondary Outcomes (4)

• Evaluation of participants' satisfaction

  Immediately post intervention

• To assess the application of the acquired knowledge in clinical practice

  Pre-intervention (T0), Immediately post-intervention (T1), and at 6 months (T2)

• To evaluate patient outcomes in terms of increased delirium recognition by ICU nurses

  Pre-intervention (T0) and post-intervention (T1) until the target sample size is achieved.

• Questionnaire Validation

  During the study period, after the required sample size for questionnaire validation has been reached.

Study Arms (1)

ICU Delirium PlayBook Nurse Training Group

OTHER

ICU nurses participating in the study will receive a structured educational intervention based on the ICU Delirium PlayBook, a multimedia training program consisting of video-based modules focused on delirium prevention, identification, and management using the CAM-ICU tool. Outcomes including knowledge, attitudes, and clinical practice related to delirium assessment will be measured before the intervention and at 6 months follow-up. In parallel, clinical data will be collected from medical records of ICU patients during both the pre-intervention and post-intervention periods to evaluate delirium incidence and recognition rates by staff nurse. These patient-level outcomes will be used to assess changes in clinical practice following the educational intervention.

Behavioral: ICU Delirium PlayBook educational program

Interventions

ICU Delirium PlayBook educational program BEHAVIORAL

This intervention consists of a structured educational program for intensive care unit nurses based on the ICU Delirium PlayBook. The program includes a series of short multimedia videos (approximately 5-8 minutes each) covering theoretical concepts of delirium, risk factors, prevention strategies, and practical guidance on the use of the CAM-ICU tool for delirium assessment. The training is delivered in a single in-person session lasting approximately 4 hours and integrates clinical scenarios to support applied learning. The aim is to improve nurses' knowledge, attitudes, and clinical practices regarding delirium recognition and management in critically ill patients.

ICU Delirium PlayBook Nurse Training Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• nurses working in the ICU of the Pisa University Hospital (AOUP).
• nurses with at least 12 months of professional experience in intensive care.

You may not qualify if:

• Nurses who do not provide informed consent

Sponsors & Collaborators

• Nicola Pagnucci: lead

Study Sites (1)

Pisa University Hospital

Pisa, PI, 56121, Italy

RECRUITING

Related Publications (3)

• Delirium: prevention, diagnosis and management in hospital and long-term care. London: National Institute for Health and Care Excellence (NICE); 2023 Jan 18. Available from http://www.ncbi.nlm.nih.gov/books/NBK553009/

  PMID: 31971702 BACKGROUND

• Makhija H, Fine JM, Pollack D, Novelli F, Davidson JE, Cotton SA, Diaz De Leon B, Reyes PA, Montoya JL, Arroyo-Novoa CM, Figueroa-Ramos MI, Song Y, Fuentes AL, LaBuzetta JN, Moore AA, Ely EW, Malhotra A, Needham DM, Martin JL, Kamdar BB. Development and Validation of an ICU Delirium Playbook for Provider Education. Crit Care Explor. 2023 Jul 13;5(7):e0939. doi: 10.1097/CCE.0000000000000939. eCollection 2023 Jul.

  PMID: 37457918 BACKGROUND

• Kamdar BB, Makhija H, Cotton SA, Fine J, Pollack D, Reyes PA, Novelli F, Malhotra A, Needham DM, Martin JL. Development and Evaluation of an Intensive Care Unit Video Series to Educate Staff on Delirium Detection. ATS Sch. 2022 Sep 23;3(4):535-547. doi: 10.34197/ats-scholar.2022-0011OC. eCollection 2022 Dec.

  PMID: 36726713 BACKGROUND

MeSH Terms

Conditions

Confusion; Delirium

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders

Study Officials

• Nicola Pagnucci, RN, MSN, PhD

  University of Pisa

  STUDY DIRECTOR

Central Study Contacts

Nicola Pagnucci, RN, MSN, PhD

CONTACT

+393472483475; nicola.pagnucci@unipi.it

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Senior Researcher

Model Details: This is a single-center, quasi-experimental pre-post interventional study. The study evaluates the impact of an educational intervention (ICU Delirium PlayBook) delivered to intensive care unit nurses. Outcomes are assessed before and after the intervention to measure changes in nurses' knowledge, attitudes, and clinical behaviors related to delirium management, as well as selected patient outcomes including delirium detection rates

Study Record Dates

• First Submitted: July 27, 2026
• First Posted: August 12, 2026
• Study Start: October 1, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): November 1, 2026
• Last Updated: August 12, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)