Effectiveness of educational programs on the Confusion Assessment Method for the ICU (CAM-ICU) in enhancing ICU delirium knowledge and skills among nurses

Background: ICU delirium is underrecognized despite its high prevalence and adverse outcomes. The Confusion Assessment Method for the ICU (CAM-ICU) is a validated screening tool, but its use by nurses is inconsistent. Objective: To systematically review evidence on the effectiveness of educational programs teaching CAM-ICU in enhancing ICU nurses’ knowledge, skills, confidence, and adherence to delirium screening. Methods: Searches were conducted in PubMed, Scopus, CINAHL, Web of Science, and Google Scholar for studies from 2019–August 2025. Eligible studies involved ICU nurses, provided an educational intervention on CAM-ICU, and assessed knowledge, skills/accuracy, self-efficacy, or screening adherence. PRISMA guidelines were followed. Results: Twelve studies (1 RCT, 8 quasi-experimental, 3 QI initiatives) met inclusion. Across designs, educational programs improved delirium knowledge, assessment accuracy, self-confidence, and adherence to CAM-ICU documentation. Multimodal interventions (lectures, case-based learning, simulation, competency checks, and audit-feedback) were associated with the most sustained improvements. Conclusions: CAM-ICU–focused nurse education consistently enhances knowledge, skills, and adherence. Implementation into standard orientation, competency-based assessments, and delirium bundles is recommended.