目的 了解重症护士对重症监护室意识模糊评估量表（confusion assessment method for the ICU,CAM-ICU）的认知和实践情况，探索应用CAM-ICU量表评估谵妄的障碍因素，为提高CAM-ICU量表的应用率提供参考。方法 2024年9月至2025年2月，采用目的抽样法选取重庆、成都市4所三级甲等医院的11名重症护士为研究对象进行半结构式深入访谈，根据Colaizzi 7步分析法对访谈资料进行整理分析。结果 重症护士应用CAM-ICU量表的障碍因素可提炼为3个主题：护士层面因素阻碍谵妄评估的有效实施，工具适用性不足限制谵妄评估的常规化开展，组织支持缺失削弱谵妄评估的持续推进。结论 护理管理者应根据护士应用CAM-ICU量表的障碍因素，构建“能力建设-工具革新-组织保障”三位一体的系统性策略，以提升谵妄评估率，进而改善患者结局。

Objective To understand ICU nurses’ knowledge and practice patterns regarding the Confusion Assessment Method for the ICU (CAM-ICU scale ) and identify barriers to its implementation for delirium assessment,thereby providing references for improving CAM-ICU utilization.Methods From September 2024 to February 2025,11 critical care nurses from four tertiary A hospitals in Chongqing and Chengdu were purposively sampled for semi-structured in-depth interviews.Interview data were analyzed using Colaizzi’s 7-step analysis method.Results Barriers to CAM-ICU scale application by critical care nurses were categorized into three themes:nurse-related factors hindering effective delirium assessment,insufficient tool applicability limiting routine delirium assessment and lack of organizational support undermining the sustained advancement of delirium assessment.Conclusions Nursing managers should construct a tripartite systemic strategy integrating “capacity building-tool innovation-organizational support” based on the identified barriers to nurses’ application of the CAM-ICU scale,to improve the delirium assessment rates and enhance patient outcomes.

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重庆医科大学护理学院协同创新项目（20240204）