The implementation of a nonpharmacologic protocol to prevent intensive care delirium

Rivosecchi, Ryan; Kane‐Gill, Sandra L.; Svec, Sue; Campbell, Shauna; Smithburger, Pamela L.

doi:10.1016/j.jcrc.2015.09.031

Cited by 76 publications

(113 citation statements)

References 29 publications

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“…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

2,584

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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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

2,584

2,938

View full text Add to dashboard Cite

show abstract

“…[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Delirium prevention is primarily conducted by the bedside nurse; however, with increasing demands on bedside nurses' time for other patient-care activities, nonpharmacologic delirium-prevention activities may not be a primary focus. [31][32][33] Solutions need to be investigated to increase delirium-prevention endeavors.…”

mentioning

confidence: 99%

Perceptions of Families of Intensive Care Unit Patients Regarding Involvement in Delirium-Prevention Activities: A Qualitative Study

Smithburger

Korenoski

Alexander

et al. 2017

Critical Care Nurse

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BACKGROUND Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient’s family are needed. OBJECTIVE To gain insight into opinions of patients’ families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients’ families in such activities. METHODS Purposeful sampling was used. Patients’ families were contacted to be interviewed about their opinions and attitudes on participation in nonpharmacologic delirium prevention activities while visiting the intensive care unit. An interview guide was created and used to facilitate discussion. Interviews were conducted, transcribed verbatim, and coded by 2 independent coders. Themes were identified, defined, and compared between independent coders; disagreements were resolved by the study team. RESULTS After 10 interviews were conducted, thematic saturation occurred. Three major themes emerged: (1) consistent family presence and participation in care, (2) improving ease of interactions between family and patient, and (3) delirium education for families. CONCLUSION Family members want to be involved with care and delirium prevention; however, many times they do not know what to do without the direction of a health care provider. Family members would benefit from open dialogue with the bedside nurse to increase family comfort and involvement in care.

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“…The multicomponent intervention studies, many of which were not randomized, evaluated a bundle of interventions. 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).…”

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

230

View full text Add to dashboard Cite

The implementation of a nonpharmacologic protocol to prevent intensive care delirium

Cited by 76 publications

References 29 publications

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

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

Perceptions of Families of Intensive Care Unit Patients Regarding Involvement in Delirium-Prevention Activities: A Qualitative Study

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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