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ICU Research Project

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by kjacks759 kjacks759 (New Member) New Member

86 Visitors; 5 Posts

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Hey all--

Just wanted to gather some guidance from you all. I'm in a nurse residency program for the ICU I'm working in as a post-grad and we have to submit a topic proposal for an evidence-based project.

Here's what I've gotten so far:

"For patients in the ICU who have dementia as a comorbidity, how does a combination of light therapy and nightly melatonin administration, compared to the use of antipsychotics, sedation, and/or restraints, affect the patient's length of stay in the hospital."

 

If you have any suggestions on how to make my topic clearer or a better way to rearrange the structure, please let me know!

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6,988 Visitors; 945 Posts

Do you mean icu delirium or dementia? I’ve never once treated dementia with melatonin in the icu.  Now, to help with delirium and getting them on a sleep/wake cycle, sometimes melatonin is used.  

Dementia is a different animal.  But those with dementia are much more susceptible to icu delirium.  

Is there clinical evidence showing it works?  

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86 Visitors; 5 Posts

From what I've gathered, the terms are almost used synonymously in research. I've seen a lot of research done for ICU delirium, but I was wanting to focus more on the sundowning aspect of dementia. Here are a few of the articles I've started reading through.

 

Keep dementia patients safe.pdf

Sundown Syndrome.pdf

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6,988 Visitors; 945 Posts

The thing is, they are not the same thing.  Melatonin actually looks like it can adverse affects with people with dementia.

Dementia patients are much more at risk for icu delirium.  The elderly in general can be.  

For your paper, just be specific also as to what type of dementia you are studying.  I would also be specific as to what type of icu you are studying.  I work in a Neuro icu.  We see lots of delirium.  Especially when you are waking people up every hour for a Neuro assessment for days on end.  

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4,872 Visitors; 389 Posts

23 hours ago, kjacks759 said:

"For patients in the ICU who have dementia as a comorbidity, how does a combination of light therapy and nightly melatonin administration, compared to the use of antipsychotics, sedation, and/or restraints, affect the patient's length of stay in the hospital."

This is so sweeping and broad it will be almost impossible to measure in a meaningful way. Length of stay is affected by so much more than just how we manage delirium, not to mention that those with longer stays are inherently at far greater risk for ICU delirium.

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