Preventing Delirium in Critically Ill Patients.

Abstract

We know from the evidence that delirium is bad for patients; it leads to longer hospital stays and increases their risk of injury. We know from our experience that delirium is also bad for caregivers; providing care for patients with delirium is stressful and can affect health-care team dynamics.The best treatment for delirium is prevention, which can be achieved through a multipronged approach, often called a “bundle,” to address the diverse causes of delirium simultaneously.In describing the implementation of a nurse-led delirium prevention bundle, authors Smith and Grami offer important lessons. Their project demonstrates the impact nurses have on patient safety. The second lesson comes from some of the challenges they faced in implementing their bundle, which included sedation cessation, pain management, sensory stimulation, early mobility, and sleep promotion. Staffing issues, family concerns, and doctors’ orders can affect implementation of the bundle.Whereas nurse leadership can effect change, we can extend our impact if we garner support from others. Patients, families, and the health care team all benefit from delirium prevention and can all play a part in implementing change.