Accuracy of delirium risk factors in adult intensive care unit patients

Abstract

Objective: To assess the accuracy measurements for predisposing and precipitating Risk Factors for delirium in an adult Intensive Care Unit. Method: Cohort, prospective study with patients over 18 who had been hospitalized for over 24 hours and were able to communicate. The patients were assessed once a day until the onset of delirium or permanence in the Intensive Care Unit. Instruments were employed to track delirium, characterize the sample, and identify the risk factors. Descriptive statistics was employed for sample characterization and accuracy tests for risk factors. Results: The included patients amounted to 102, 31 of which presented delirium. The predisposing predictive risk factors were hypoalbuminemia, American Society of Anesthesiology over three, severity, altered tissue perfusion, dehydration, and being a male, whereas precipitating predictive factors were physical restraint, infection, pharmacological agent, polypharmacy, anemia, altered renal function, dehydration, invasive devices, altered tissue perfusion and altered quality and quantity of sleep. Conclusion: An accurate identification of predisposing and precipitating risk factors may contribute to planning preventive measures against delirium.

Nursing microtheory in the prevention of delirium in older adult in the intensive care unit

“…Still, the unknown environment, distance from family and friends become facilitating factors for the emergence of complications in older adult hospitalized in the ICU. These factors trigger physical and psychological impacts, which often go beyond what the older adult has already experienced, making them more prone to triggering delirium ( 28 ) . Thus, the hospitalization of the older adult in the ICU requires the promotion of strategies for the prevention of delirium by the nursing team, in order to encourage coping and adaptation in the intensive environment ( 29 ) .…”

Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos

“…Sin embargo, el entorno desconocido, la separación de familiares y amigos se convierten en factores facilitadores para la aparición de complicaciones en personas mayores ingresadas en la UCI. Estos factores desencadenan impactos físicos y psicológicos que, en muchas ocasiones, van más allá de lo que la persona mayor ha experimentado, haciéndola más propensa a desarrollar delirium (28) . Por lo tanto, la hospitalización de personas mayores en la UCI requiere la implementación de estrategias de prevención del delirium por parte del equipo de enfermería, con el fin de fomentar el afrontamiento y la adaptación en el entorno intensivo (29) .…”

Microteoria de enfermagem na prevenção do delirium em pessoas idosas na unidade de terapia intensiva

“…Ainda, o ambiente desconhecido, o afastamento dos familiares e amigos tornam-se fatores facilitadores ao surgimento de complicações em pessoas idosas internadas na UTI. Estes fatores desencadeiam impactos físicos e psicológicos, que, muitas vezes, vão além do que a pessoa idosa já experienciou, tornando-a mais propensa ao desencadeamento do delirium (28) . Dessa forma, a hospitalização da pessoa idosa na UTI requer a promoção de estratégias para prevenção do delirium pela equipe de enfermagem, a fim de estimular o enfrentamento e adaptação no ambiente intensivo (29) .…”