80% of the sickest patients in the ICU will suffer from delirium. They have multiple risk factors that include immobility, medications for pain and sedation, and interrupted circadian rhythms, just to name a few. Delirium in the ICU will complicate the patients stay and can lead to many adverse outcomes. Patients who suffer from delirium will often be combative, pull out catheters, be unable to participate in therapy, and they may even self-extubate. These adverse outcomes can be hard on patients, families and ICU staff. Education about delirium should be provided to family members when applicable. ICU delirium will also increase the total cost of a patient’s stay.
ICU staff should have a system in place for assessing delirium such as the CAM-ICU. Their CAM-ICU score should be reported regularly in the EHR and during rounds. If staff is consistently reporting on delirium they can aim their interventions towards minimizing any adverse outcomes. Interventions will range from reducing certain medications, increasing mobility during the day , reducing stimulation at night, and to introducing cognitive therapy with an Occupation Therapist.
Delirium in the ICU is prevalent and also somewhat preventable. By tracking and addressing the following six risk factors our patients will have less complications: sleep deprivation, immobility, visual impairment, hearing impairment, cognitive impairment and dehydration.