Organizational Policies and Norms Affect Nurse Diagnosis of Delirium in ICU

​Although early recognition and prevention of delirium are crucial tasks, particularly in elderly patients in the intensive care unit (ICU), there is limited literature regarding the strategies and processes that ICU nurses use to recognize the condition. Authors of an article in the October 2015 Journal of Gerontological Nursing followed 17 providers in three Canadian hospitals, identifying institutionalizing clinical reasoning—that is, the organizational and political structure of the hospital in which the nurses are working—as the theory that governs their behaviors. Indeed, they found, hospitals and unit policies and normalized behaviors shape nurses' clinical reasoning.