Table 2.

Comparison of barriers found by the first survey versus the results of the second survey

	Before	After
(A) Attitudes and perceptions	%*
Delirium occurrence and importance
Delirium is preventable	21	15
Screening	%*
Is a nurse capable to identify delirium with a validated delirium screening instrument?	34	80
Collaboration	%*
When I as nurse suspect a patient to be delirious, I am satisfied with delirium treatment	47	40
When I as physician suspect a patient to be delirious, the nurse is satisfied with delirium treatment	42	11
Collaboration between doctors and nurses with regard to delirium at the ICU can be improved by better screening	65	30
Collaboration between doctors and nurses with regard to delirium at the ICU can be improved by routinely addressing delirium in daily rounds	74	78
(B) Current practices
Delirium screening	%*
In the ICU unit where I work the following delirium screening scale is in use:
CAM-ICU (Before: n=210; in only two hospitals / After: n=119)	58	45
ICDSC (before: n=3/after: n=104)	<1	39
Delirium prevention
Earplugs for the night	8	24
Family visits as much as possible	50	61
(C) Guideline adherence (n=136)
If I follow the guideline recommendations, it is likely that my patients would not receive optimal care†	3.1 (1.0)	1.9 (1.1)
I do not wish to change my delirium care practices, regardless of what delirium guideline recommends†	3.7 (1.0)	1.4 (1.0)
I don’t have time to use this guideline†	3.5 (0.9)	1.7 (1.0)
This guideline is cumbersome and inconvenient†	3.0 (1.1)	2.0 (1.1)
(D) Guideline adherence in general (n=128)
Generally, guidelines are cumbersome and inconvenient†	3.0 (0.9)	2.2 (0.9)
Guidelines are difficult to apply and adopt to my specific practice†	3.1 (0.9)	2.0 (0.9)
Guidelines interfere with my professional autonomy†	3.3 (0.9)	1.7 (0.9)
Generally, I would prefer to continue my routines and habits rather than to change† based on practice guidelines†	3.3 (1.0)	1.9 (0.9)
I am not really expected to use guidelines in my practice setting†	3.7 (0.9)	1.4 (1.0)

*= % agreement (= %YES answers or % of the sum of agree and strongly agree answers (from the 5-point Likert Scale statements)). Barriers depends on the question formulation. For positive formulated the barrier is ≤50% and negative formulated the barrier is ≥50%.

†= mean and SD based on the six-point Likert Scale. Mean score of ≥3 was considered to indicate agreement with statement=Barrier.

CAM-ICU, Confusion Assessment Method for the ICU; ICDSC, Intensive Care Delirium Screening Checklist; ICU, intensive care unit.