Delirium in Icu

1940 Words Oct 22nd, 2015 8 Pages
MANAGEMENT OF DELIRIUM IN THE ICU
Colleen Gottlieb
Erica Powell
Mary Tool
July 16, 2013 **think this has to be double spaced

Management of Delirium in the ICU
Introduction

Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence
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With each additional risk factor the likely hood of developing delirium increases. Not only does delirium increase the cost of patients stay it can also increase the mortality rate. Of all diagnosed delirious patients 25% will likely have permanent cognitive impairments, and more critically, those patients who do develop delirium have a three to five fold increase in mortality.
The importance of assessing for delirium cannot be stressed enough. Dr Tsuei preformed a study that demonstrated frequent assessment, categorized as every four awake hours, increased the detection of delirium by 55% compared to a once daily delirium assessment. This indicates that once daily assessment for delirium is not sufficient and no assessment is severely deficient. In assessing for delirium every four awake hours, we increase the reporting and thus treatment of this fatal illness. Though there is no specific treatment for delirium at this time certain medication recommendations have been made as well as improving nursing interventions to decrease delirium. The American Association of Critical Care Nursing, AACN recommends the use of the ICDSC and the CAM-ICU for assessment of delirium. The ICDSC has been in use since 1990 and the CAM since 2001. The CAM is broken down into four separate components that must be established in order. First one must determine if the patient’s mental status is different from their baseline. Second, identify if the patient is suffering from
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