Meako et al. 2011, USA [24]

Examine Orthopaedic nurses’ basic knowledge about delirium and test the effectiveness of 1 hour teaching session about it

-Orthopaedic RNs have a lack in understanding delirium

-The one hour educational session is effective to raise RNs awareness


Quasi-experimental design allowed accuracy in findings and validation.


The study was liable to participants drop out.

Steeg et al. 2015, Netherlands [25]

Test the effectiveness of an e-learning course on nurses’ delirium knowledge and explore their knowledge about delirium,

-Test scores on the final knowledge test were significantly higher than

-At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk


Randomisation minimised sample bias


Pre and post design is open to respondent attrition.

Rice et al. 2014, south-eastern, USA [26]

Increase recognising delirium clinical reasoning for older adults in nurses, and provide clinical reasoning processes according to participants to validate these interventions

-It was difficult for nurses to distinguish acute versus chronic mental status changes, especially in dementia patients

-The nurses’ use of intuitive assessment of patients involved immediate knowledge that was not mediated through rational and analytical processes

-Nurses recognise that delirious patients require different care and that being confused altered their prognosis


The study had varied sample from different wards

The study used validated tools


The use of interviews exposed it to respondent bias