Blended Teaching Improves Delirium Assessment and Ensures 100% Patient Screening by Nurses

Introduction: Delirium is a common yet under-recognized condition in intensive care units (ICUs), with serious consequences for patient outcomes. Early detection and appropriate management by nursing staff are critical. This study aimed to evaluate the effectiveness of a structured educational intervention—combining virtual learning, didactic teaching, and simulation—in enhancing knowledge, attitude, and practice of ICU nurses toward delirium assessment.


Methods: A quasi-experimental study was conducted with registered nurses from the surgical ICU at Aga Khan University. The intervention included five phases: pre-test, virtual learning, face-to-face teaching, simulation training, and repeat simulation after three months. A validated questionnaire assessed knowledge and attitude at each stage. Statistical analysis was performed using paired t-tests and repeated measures ANOVA.


Results: Fifty-seven nurses participated. Mean knowledge scores improved significantly from 13.49 ± 4.85 (pre-test) to 18.54 ± 4.37 (post-test) (p < 0.001). Attitude scores also increased from 60.75 ± 6.88 to 64.56 ± 9.74 (p < 0.001). Further improvements were observed following face-to-face sessions and simulations. Delirium recognition rates reached 100% during simulation-based assessments. The intervention led to a statistically significant and sustained improvement in both knowledge and attitude.


Conclusions: A blended teaching approach incorporating virtual modules, lectures, and simulation significantly improves ICU nurses' competency in delirium assessment. Simulation reinforced learning and promoted sustained behavioral change. This model can be adapted for similar clinical education initiatives to improve patient safety and care outcomes