Improving delirium knowledge and recognition confidence in nursing homes through an e-learning program: a pre–post study

Delirium is a neuropsychiatric syndrome associated with serious complications. Residents of nursing homes are particularly vulnerable to developing delirium. Nurses play a key role in the prevention, detection, and management of delirium but often report a lack of specific knowledge and understanding. The aim of this study was to develop and evaluate a tailored e-learning programme on delirium for nurses working in German nursing homes. This pilot study employed a single-group pre-post design. Between January and March 2025, nurses from German nursing homes completed a delirium-specific e-learning program consisting of five modules on risk factors, causes, prevention, symptoms, diagnosis, and treatment. Participants completed a delirium knowledge questionnaire and rated their confidence in recognizing delirium before and after training. Evaluation questions assessed usability and relevance. A total of 80 nurses completed the e-learning program as well as the pre- and posttests. Delirium-specific knowledge improved from a median of 32 to 40 correct answers (interquartile range [IQR] = 9.25 vs. 7.5; p < 0.001). Subjective confidence in recognizing delirium increased from 5 to 7 (IQR = 2.25 vs. 1; p < 0.001) on a 10-point scale. Both improvements showed large effect sizes (knowledge: r = 0.86; subjective confidence: r = 0.92). Most nurses rated the training as highly relevant and usable. Residents of nursing homes are at increased risk of delirium, while nursing staff report a clear need for delirium-specific expertise. Findings from this pilot study suggest that the tailored e-learning program may enhance nurses’ knowledge and confidence in recognizing delirium. The program represents a promising foundation for structured delirium training in nursing homes and warrants further evaluation in larger and long-term studies.