The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial

Moon, Kyoung-Ja; Lee, Sun-Mi

doi:10.1016/j.ijnurstu.2015.04.021

Cited by 82 publications

(134 citation statements)

References 45 publications

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“…Glasses and hearing devices were made available to ensure the sensory ability; indirect light was promoted to improve sleep at night, and family members bring personal items from patients was allowed. However, in this case, the results showed no significant difference between the control and intervention groups regarding the incidence of delirium in the univariate analyzes (OR: 0.5 (IC: 0.22-1.14, P=0.1)) and multivariate (OR: 0.52 (IC: 0.23-1.21, P=0.13)) (25) .…”

Section: Discussioncontrasting

confidence: 56%

“…The studies that addressed care for the promotion of sleep are still incipient and their results do not converge much (22)(23)(24)(25)(26)(27)(28)(29) . However, it is important to observe that the association of multiple interventions, including the administration of antipsychotics, seems to favor the solution of delirium, but clinical studies with more robust designs are still necessary.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revisão integrativa

Souza

Azzolin

Fernandes

2018

Rev. Gaúcha Enferm.

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Objective: To describe the multiprofessional care for the management of critical patients in delirium in the ICU from the evidences found in the literature.Methods: This integrative review was carried out in the period from February 1 to June 30, 2016 through searches on PubMed, Scopus, Web of Science, and CINAHL, with the following descriptors: delirium, critical care e intensive care units, which brought up 17 original papers. Results:A bundle and a guideline, two systematic reviews, evidence 1a and four clinical trials, evidence 1b and 2b, cohort and observational studies were found. The multiprofessional care was presented to better understand the diagnosis of delirium, sedation pause, early mobilization, pain, agitation and delirium guidelines, psychomotor agitation, cognitive orientation, sleep promotion, environment and family participation. Conclusion:The care for delirium is wide and not specific, which determines its multifactorial aspect. Keywords: Delirium. Intensive care units. Critical care. Patient care team. Review. RESUMO Objetivo: Descrever os cuidados multiprofissionais para manejo de pacientes críticos em delirium na UTI a partir das evidências encontradas na literatura.Métodos: Trata-se de uma revisão integrativa realizada no período de 1º de fevereiro a 30 de junho de 2016, através de busca nas bases de dados PubMed, Scopus, Web of Science e CINAHL, com os descritores delirium, critical care e intensive care units que finalizou com 17 estudos originais. Resultados:Foram encontrados um bundle e uma diretriz, duas revisões sistemáticas, evidência 1a e quatro ensaios clínicos, evidência 1b e 2b, os demais estudos de coorte e observacionais. Os cuidados multiprofissionais foram apresentados para melhor entendimento em diagnóstico de delirium, pausa de sedação, mobilização precoce, diretrizes para dor, agitação e delirium, agitação psicomotora, orientação cognitiva, promoção do sono, ambiente e participação da família. Conclusão:Os cuidados para delirium são abrangentes e pouco específicos, determinando seu aspecto multifatorial. Palavras-chave: Delírio. Unidades de terapia intensiva. Cuidados críticos. Equipe de assistência ao paciente. Revisão. RESUMEN Objetivo: Se objetivó describir los cuidados multiprofesionales para manejo de pacientes críticos en delirium en la UCI, a partir de las evidencias encontradas en la literatura.Métodos: Se trata de una revisión integradora, realizada en el período del 1 de febrero al 30 de junio de 2016 a través de búsqueda en PubMed, Scopus, Web of Science, y CINAHL con descriptores delirium, critical care e intensive care units que finalizó con 17 estudios originales.Resultados: Se encontraron un bundle, una directriz, dos revisiones sistemáticos, evidencia 1a, cuatro ensayos clínicos, evidencia 1b y 2b, los demás estudios de cohorte y observacionales. Se presentaron los cuidados multiprofesionales para una mejor comprensión de diagnóstico de delirium, pausa de sedación, movilización temprana, directrices para el dolor, agitación, y delirium, agitación...

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revisão integrativa

Souza

Azzolin

Fernandes

2018

Rev. Gaúcha Enferm.

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“…Studies of multicomponent interventions, many of which were not randomized, focus on cognitive impairment (e.g., reorientation, cognitive stimulation, music, use of clocks); sedation/sleep disruption (e.g., reducing sedation, minimizing light and noise); immobility (early rehabilitation/mobilization); and hearing and visual impairment (e.g., use of hearing aids and glasses). Overall, the use of such strategies reduced delirium significantly (five studies, n = 1,318; OR, 0.59; 95% CI, 0.39-0.88) (392)(393)(394)(395)(396). Further, ICU duration of delirium (16 vs 20 hr) (395), ICU LOS (387), and hospital mortality all decreased (393).…”

Section: Multicomponentmentioning

confidence: 99%

“…Rationale: The multicomponent intervention studies evaluated a bundle of interventions. Many examples of multicomponent bundles (8,283,(391)(392)(393)(394)(395)(396) have shown improved outcomes in critically ill adults (Supplemental Table 29, Supplemental Digital Content 37, http://links.lww.com/CCM/ D795). Pilot studies suggested that combining cognitive and physical therapy early during critical illness is feasible and safe (391) and using nonpharmacologic multicomponent interventions in ICU patients is feasible (392).…”

Section: Multicomponentmentioning

confidence: 99%

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Devlin

Skrobik

Gélinas

et al. 2018

Critical Care Medicine

2,591

2,938

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We found substantial agreement among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults. Highlighting this evidence and the research needs will improve Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) management and provide the foundation for improved outcomes and science in this vulnerable population.

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“…Overall, the use of such strategies significantly reduced delirium (76,80). Further, ICU duration of delirium in patients who developed it (79), ICU LOS (76), and hospital mortality all decreased (77). Another multiple intervention approach, the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle, was significantly associated with less delirium in a before-after study (81).…”

Section: Multicomponent Nonpharmacologic Prevention and Treatmentmentioning

confidence: 95%

Executive Summary: Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Devlin

Skrobik

Gélinas

et al. 2018

Critical Care Medicine

233

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The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial

Cited by 82 publications

References 45 publications

Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revisão integrativa

Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revisão integrativa

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Executive Summary: Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

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