Delirium in the Intensive Care Unit—A Nursing Refresher.

Delirium is a frequent, yet poorly assessed and managed complication in the intensive care unit (ICU). Morbidity and mortality increase with delirium; and the cognitive impairment often persists after hospital discharge affecting quality of life and ability to function independently. Interdisciplinary delirium prevention and mitigation strategies are necessary to effectively assess and manage this syndrome with critical care nurses playing a key role in the process. Lack of nursing knowledge has been identified as a key barrier to comprehensive delirium assessments. Understanding delirium, including the identification of key presenting symptoms, and associated risk factors, is essential for bedside nurses to employ effective assessment and management strategies. This article provides nurses with a concise review of delirium from assessment to management for critically ill patients in the adult ICU environment. Delirium is a frequent complication in the intensive care unit (ICU). Previously considered an inevitable and unimportant side effect of critical illness, its incidence is higher than initially realized; it significantly impacts morbidity and mortality, healthcare costs, and other long-term effects on the patient and society (Devlin, Brummel, & Al-Qadheeb, 2012). As a result, the Society of Critical Care Medicine (SCCM) released clinical practice guidelines for the management of pain, agitation, and delirium (PAD) recommending an interdisciplinary management approach and the use of validated screening tools (Barr et al., 2013). Despite the explosion of research on the pathophysiology of delirium, its prevention, management, and mitigating long term sequelae, delirium in the ICU remains poorly understood and assessed by many nurses. [ABSTRACT FROM AUTHOR]