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Nurses' Perceptions and Experiences of Paediatric Emergence Delirium in the Post‐Anaesthesia Care Unit: An Interpretative Qualitative Study

ABSTRACT

Aim

To explore post-anaesthesia care unit nurses' perceptions and experiences in managing paediatric emergence delirium, and to understand their experiences in implementing the Cornell Assessment of Paediatric Delirium—Traditional Chinese version tool in clinical practice following delirium-focused education.

Methods

This interpretive qualitative study involved 20 nurses in the post-anaesthesia care unit from a medical centre hospital in Taiwan who participated in small group interviews after completing delirium-focused education. Data were collected through semi-structured interviews between October and December 2024 and analysed using a thematic analysis approach.

Findings

Five main themes were identified: (1) First impressions and reflexive actions during emergence delirium, (2) Clinical interpretation through observation and elimination, (3) The dual role of parents in emergence delirium management, (4) Negotiating trust and learning with the delirium screening tool and (5) System-level needs and recommendations. Nurses described the chaotic and emotionally charged nature of emergence delirium episodes, the intuitive yet uncertain interpretive work they performed, the complex influence of parental presence, evolving trust in structured assessment tools and systemic barriers that hindered timely emergence delirium recognition.

Conclusion

Nurses face complex clinical, emotional and relational challenges in managing paediatric emergence delirium. Embedding delirium awareness into practice requires sustained training, screening integration and proactive parental engagement.

Implications for Profession and Patient Care

Findings highlight the need for integrating delirium screening into post-anaesthesia care routines, the need for ongoing education and preparing parents for emergence delirium scenarios to enhance care delivery and safety.

Reporting

The COREQ checklist was used for reporting.

Patient or Public Contribution

No patient or public involvement.

Immigrant and minority parents' experiences in a neonatal intensive care unit: A meta‐ethnography review

Abstract

Aims

To examine immigrant and minority parents' experiences of having a newborn infant in the neonatal intensive care unit and explore healthcare professionals' experiences in delivering care to immigrant and minority families.

Design

A meta-ethnographic review informed by eMERGe guidelines.

Methods

We conducted a systematic literature review. Studies were included if they explored immigrant or minority parent experiences in neonatal intensive care units and health professional experiences delivering care to immigrant and minority families in neonatal intensive care. Reporting followed ENTREQ guidelines.

Data Sources

Database searches included CINAHL, MEDLINE, PubMed, PsycINFO, Scopus and Google Scholar. Boolean search strategies were used to identify qualitative studies. No limitations on commencement date; the end date was 23rd August 2022. PRISMA guidelines used for screening and article quality assessed using Joanna Briggs Institute criteria for qualitative studies.

Results

Initial search yielded 2468 articles, and nine articles met criteria for inclusion. Three overarching themes were identified: (1) Overwhelming Emotions, (subthemes: Overwhelming Inadequacy; Cultural Expressions of Guilt; Not Belonging), (2) Circles of Support, (subthemes: Individual Level-Spirituality; External Level-Connecting with Family; Structured Peer-to-Peer Support), (3) Negotiating Relationships with Healthcare Professionals (subthemes: Connecting; Disconnected; Linguistic Barriers). Interactions between healthcare professionals and immigrant and minority parents were the strongest recurring theme.

Conclusions

There can be a mismatch between immigrant and minority families' needs and the service support provided, indicating improvements in neonatal intensive care are needed. Despite challenges, parents bring cultural and family strengths that support them through this time, and many neonatal intensive care staff provide culturally respectful care.

Implications for the Profession and/or Patient Care

Professionals should be encouraged to identify and work with family strengths to ensure parents feel supported in the neonatal intensive care unit. Findings can inform policy and practice development to strengthen health professionals capabilities to support immigrant and minority families in neonatal units.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklists were used to report the screening process.

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