{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:00Z","timestamp":1790060460445,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delirium is a common and serious complication among critically ill patients, affecting approximately 20%\u201380% of ICU populations and contributing to increased mortality, prolonged mechanical ventilation, extended hospital stays, cognitive impairment and higher healthcare costs. Nurses play a central role in delirium prevention, assessment and management; however, deficiencies in delirium\u2010related knowledge, confidence and assessment practices remain widespread. Digital psychoeducation and delirium care bundle interventions have been increasingly implemented to address these gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To systematically review and narratively synthesize evidence regarding the effects of digital psychoeducation and ICU delirium care bundle programmes on nurses' competency, confidence and care\u2010related strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A systematic review with narrative synthesis was conducted in accordance with PRISMA 2020 and SWiM guidance. Six electronic databases (PubMed, CINAHL, Scopus, Web of Science, Embase and ProQuest) were searched. Eligible studies included quasi\u2010experimental, pre\u2013post and quality\u2010improvement studies evaluating delirium\u2010focused educational or care bundle interventions among ICU nurses. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi\u2010Experimental Studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies involving approximately 472 nurses from five countries met the inclusion criteria. Competency outcomes improved in 87.5% of studies, with delirium knowledge increasing by 100%\u2013150%, CAM\u2010ICU assessment accuracy reaching 95.5%, documentation completeness exceeding 91% and bundle compliance reaching 97.5%. Confidence improved across all studies evaluating this outcome, with increases ranging from 35.3 to 60.1 percentage points, including one study reporting a very large effect size (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20092.31). The only study assessing care\u2010related strain demonstrated a 48.8% reduction in delirium\u2010related nursing stress. Overall, educational interventions were associated with improved clinical practice indicators, although implementation varied across healthcare settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Digital psychoeducation and ICU delirium care bundle programmes consistently improve nurses' delirium\u2010related competency and confidence and may reduce care\u2010related strain. However, evidence regarding strain remains limited, and variability in clinical implementation highlights the need for more rigorous controlled studies and long\u2010term evaluations to strengthen the evidence base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Integrating digital delirium education programmes and structured care bundles into ICU nursing practice can improve nurses' competency, confidence and adherence to evidence\u2010based delirium assessment, supporting earlier recognition and higher quality patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>CRD4201380975<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70645","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:10:38Z","timestamp":1787634638000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Digital Psychoeducation and ICU Delirium Care Bundle Programmes on Nurses' Competency, Confidence and Care\u2010Related Strain: A Systematic Review and Narrative Synthesis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0375-5774","authenticated-orcid":false,"given":"Baraa I.","family":"Aldayyat","sequence":"first","affiliation":[{"name":"Department of Community Health Nursing, School of Nursing The University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-6266","authenticated-orcid":false,"given":"Ekhlas","family":"Al Gamal","sequence":"additional","affiliation":[{"name":"Department of Community Health Nursing, School of Nursing The University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2118-5257","authenticated-orcid":false,"given":"Jafar A.","family":"Alshraideh","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, School of Nursing The University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-824X","authenticated-orcid":false,"given":"Rabia H.","family":"Haddad","sequence":"additional","affiliation":[{"name":"Nursing Department, Faculty of Nursing Philadelphia University  Amman 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