Nursing in critical care
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The literature emphasizes the importance of the intensive care unit (ICU) diary to fill the gaps and recover the delusional memories of patients admitted to ICU in order to build the history of their illness. The ICU diary is a measure originally intended to support the severely ill patient, but it would also seem to be useful for family members and carers. According to our analysis of the literature, this study is the first description of the contents of ICU diaries in the Italian context. ⋯ The diaries could be adapted to the Italian context and this could make the diary a common practice in Italy as well.
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Nursing in critical care · May 2021
Mobilization in the evening to prevent delirium: A pilot randomized trial.
Delirium is a common complication in patients in Intensive Care Units (ICU). Interventions such as mobilization are effective in the prevention and treatment of delirium, although this is usually completed during the daytime. ⋯ In a mixed ICU population, mobilization in the evening was feasible in one-quarter of patients with a low rate of safety events. Future trials seem to be feasible and worth conducting.
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Nursing in critical care · May 2021
Validation of PREdiction of DELIRium in ICu patients (PRE-DELIRIC) among patients in intensive care units: A retrospective cohort study.
An intensive care unit (ICU) delirium prediction tool, PREdiction of DELIRium in ICu patients (PRE-DELIRIC), has been developed and calibrated in a multinational project. However, there is a lack of evidence regarding the predictive ability of the PRE-DELIRIC among Chinese ICU patients. ⋯ Clinicians can adopt the PRE-DELIRIC among ICU patients to screen patients at high risk of developing delirium. Early initiative interventions could be implemented to reduce the negative impacts of ICU delirium.
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Nursing in critical care · May 2021
A quality improvement project to improve the identification and management of delirium.
Efforts to reduce delirium burden through screening, identification, and prevention is considered one of the major public health priorities of the last decade. In 2017, an audit of delirium screening in our unit revealed suboptimum assessment of our patients, with compliance with the Confusion Assessment Method for the ICU (CAM-ICU) assessments highly variable and ad hoc, and sometimes not at all. A separate sedation audit also revealed that our sedation practices did not align with current critical care guidelines emphasizing light sedation strategies. ⋯ This project provides a useful framework to enable future quality improvement work around delirium and sedation management. The clinical pathway and sedation algorithm have been a useful tool to introduce to the unit as a way of formalizing the elements of delirium care and assessment.
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Nursing in critical care · May 2021
ReviewNon-pharmacologic interventions for the prevention of delirium in the intensive care unit: An integrative review.
Delirium in the intensive care unit (ICU) is associated with increased mortality, longer hospital stays, and increased odds of institutionalization after discharge. Delirium is a significant complication that occurs frequently in ICU yet lacks a standardized treatment protocol. Because of the limited effective pharmacologic treatments available for the management of delirium, non-pharmacologic interventions such as early mobilization, earplugs and blinds at night, music and natural sunlight during the day, continuous reorientation, and increased visitation and family participation are essential to integrate into the treatment plan for the management of delirium in the ICU. ⋯ Non-pharmacologic interventions used for patients in the ICU may be efficacious in reducing the incidence and duration of delirium in adults. Non-pharmacologic interventions are feasible and supported by ICU staff and patients' families and should be considered in the care of the critically ill patient.