Journal of Patient Care

Revitalizing Intensive Care Units (ICU): Nursing Interventions Redefining Delirium Management

Ron Morrison^* Department of Nursing and Midwifery, Griffith University, Queensland, Australia
^*Correspondence: Ron Morrison, Department of Nursing and Midwifery, Griffith University, Queensland, Australia, Email:

Received: 03-Jul-2023, Manuscript No. JPC-23-22593; Editor assigned: 06-Jul-2023, Pre QC No. JPC-23-22593 (PQ); Reviewed: 20-Jul-2023, QC No. JPC-23-22593; Revised: 27-Jul-2023, Manuscript No. JPC-23-22593 (R); Published: 03-Aug-2023, DOI: 10.35248/2573-4598.23.9.240

Description

Delirium is a complex and often overlooked syndrome characterized by acute cognitive dysfunction, confusion and altered awareness. It frequently occurs in critically ill adult patients, particularly those in Intensive Care Units (ICUs) and poses a significant challenge to both patients and healthcare providers. The detrimental impact of delirium on patient outcomes, including increased morbidity, mortality and prolonged hospital stays, underscores the urgency of implementing effective nursing interventions to prevent and manage this condition. Delirium, often referred to as "ICU psychosis," is a prevalent and serious condition that afflicts critically ill patients, particularly those receiving care in ICUs. It is characterized by disturbances in attention, awareness and cognitive function, often leading to confusion, restlessness and agitation. Delirium not only poses a significant burden on patients and their families but also strains healthcare resources and impacts the overall quality of care provided.

Nursing interventions are central to addressing delirium, as nurses are on the front lines of patient care and play a pivotal role in prevention, detection and management. Delirium in critically ill adults is a multifaceted syndrome influenced by a combination of factors, including the underlying medical condition, medications, sensory deprivation, sleep disruption and the ICU environment itself. Patients with delirium are more likely to experience adverse events, such as falls, removal of medical devices and self-extubation, which can further exacerbate their clinical condition. Understanding the underlying causes and risk factors for delirium is essential for devising effective nursing interventions.

Nursing interventions to reduce delirium

Assessment and screening: Regular and systematic assessment for delirium using validated tools, such as the Confusion Assessment Method for the ICU (CAM-ICU), enables early detection and intervention. Nurses should be trained in using these tools to identify delirium promptly.

Multidisciplinary communication: Collaboration between nurses, physicians, pharmacists and other healthcare professionals is essential for comprehensive delirium management. Open communication ensures that potential triggers, such as medications or infections, are promptly addressed.

Mobility and ambulation: Mobilizing critically ill patients, when feasible, can enhance cognitive function and reduce the risk of delirium. Nurses play a vital role in promoting early mobilization and ambulation to maintain patients physical and cognitive wellbeing.

Sleep promotion: Ensuring a conducive sleep environment by minimizing noise, maintaining a consistent sleep schedule and managing pain and discomfort can contribute to reducing the risk of delirium.

Orientation and cognitive stimulation: Providing orientation cues, such as clocks and calendars, and engaging patients in cognitive activities can help maintain cognitive function and reduce delirium-related confusion.

Medication management: Nurses play a critical role in administering medications and monitoring their effects. They should collaborate with physicians to optimize medication regimens, avoiding drugs known to increase the risk of delirium.

Family engagement: Involving families in the care of critically ill patients can provide comfort and support, potentially reducing delirium by reducing feelings of isolation and anxiety.

Nutritional support: Adequate nutrition and hydration are essential for maintaining cognitive function. Nurses should monitor and support patients nutritional needs to prevent delirium.

Challenges and implementation barriers

Several challenges and barriers can impede the effective implementation of nursing interventions to reduce delirium in adult critically ill patients such as:

Staffing and workload: Limited staffing and high patient acuity can hinder nurses' ability to provide comprehensive delirium prevention and management.

Education and training: Ensuring that nurses are knowledgeable and skilled in delirium assessment and interventions requires ongoing education and training.

Changing practices: Overcoming resistance to change and encouraging the adoption of evidence-based practices can be challenging within healthcare settings.

Interdisciplinary collaboration: Effective delirium management requires collaboration among various healthcare disciplines, which can be hindered by communication barriers.

Conclusion

Delirium poses a significant threat to the well-being and outcomes of critically ill adult patients in ICUs. Implementing evidence-based nursing interventions is essential for reducing the incidence and severity of delirium, ultimately improving patient outcomes and reducing healthcare costs. As advocates for patient well-being, nurses play a central role in the prevention, early detection and management of delirium. By addressing modifiable risk factors, promoting interdisciplinary collaboration, and advocating for best practices, nurses can contribute significantly to enhancing the care and quality of life for critically ill adult patients at risk of delirium.