Delirium prevention in ICU

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Specializes in infusion therapy, wound care.

Hello to all. I'd very much appreciate any help you can give me. This is the situation: a student nurse for her graduation thesis (RN) ask me to find some material that addresses the issue of what a nurse can do regarding the prevention of delirium in the ICU Unit. I found a lot of medical related stuff, but very little regarding what nurses can, and should do, based on scientific evidence. Are there any guidelines, protocols, procedures, policies that could be taken in to account? Thank you for your help, and time.

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Specializes in Telemetry/Med Surg.

Just do a google search using critical care delirium nursing

there's a lot of publications that come up.

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Specializes in ER/ICU, CCL, EP.

Also search. "ICU Psychosis"

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Specializes in infusion therapy, wound care.

Thanks, I'll try some more times with Google. The most interesting articles that I've encountered have to be payed for, and that makes me give up. Other articles (so many of them...) are not quite centered on the nurses role. I'll try to help her out with what I've got.

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

You can still pull the titles of the articles for the student to look up in her database at school. She should at least have access to CINAHL for peer-reviewed nursing articles, hopefully. ;)

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Specializes in ICU.

There is alot you can do to prevent ICU delerium, or minimize it. Trying not to wake the pt in the middle of the night too often, only when necessary, don turn on the bright lights in the middle of the night, keep them awake during the day if you can, provide stimulation, keep the tv on...although sometimes the pt's halucinate with the tv. We had a patient who thought the room was on fire...we had the tv turned to the fire log chanel they put on every christmas season. Ive learned to do alot of stuff in the dark if I can, or very minimal light. Provide lots of re-orientation...alot of times, you tell them they are in hospital, and they forget 10 minutes later.

Theres alot of other factors tha contribute depending on the pt's diagnosis...alcohol withdrawl, head injury, sepsis, fever, hypoxia, narcotics for pain conrol...some people recact badly to them. Also sedatives may work in the short term to control patients, sometimes, especially in the elderly, they get more confused.

We just stared instituting a delerium and behavioural pain scale system in our ICU to better manage pain and delerium. Each nurse is to give the patient a score, and we can better see on paper "how delerious" the patient is. Also then the physicians can see on rounds if the patient it worse/ better, so there is better communication among the team. Hope this helps somewhat.

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Specializes in infusion therapy, wound care.

A very big thank you for helping me out. Unfortunately the RN student doesn't Know the English language well enough to understand it.

I already had to translate some scientific papers for her and will again if she'd need some other ones translated.

I will show her all your responses and make sure there's an understanding. I think "we" now have enough information to study and learn.

Thanks again.

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