Recognizing and Preventing ICU Delirium in Intensive Care : a descriptive literature review

ICU delirium is a poorly known life-threatening condition unless diagnosed and treated early. ICU delirium risks factors are known however, it remains misdiagnosed or underdiagnosed. The purpose of this thesis is to identify factors affecting recognition of ICU delirium and the available preventive interventions in intensive care unit. The aim is to produce knowledge that could be used in developing and improving ICU delirium management in intensive care. Thesis topic was done as part of HUS (Helsingin ja Uudenmaan Sairaanhoitopiiri) neuro centre and Metropolia UAS collaboration. The COVID-19 pandemic caused intensive care units overly capacitated with patients in need of intensive care. This made the implementation of ICU delirium assessment and preventive measures almost unachievable due to lack of additional resources. The data of recognition of ICU delirium and the preventive measures was collected from the following reliable sources; CINAHL, Medline and Medic. With the use of key terms, initial search result were 5,352 articles of which ten articles were utilised. Inductive content analysis was used to analyse the results that answered research questions; How is ICU delirium recognized by nurses in intensive care unit? and How could the ICU delirium be prevented? Result of the study states that nurses have poor knowledge and perception of ICU delirium and there is a need for additional training. Nurses were familiar with ICU delirium assessment tools and existing non-pharmacological interventions. Nurses with long work experience have attitude that influence their adherence to the ICU delirium guidelines, by relying on their personal judgement instead of using assessment tools. Moreover, several ICU delirium preventive interventions were revealed. Hospital management should provide nurses with further education on ICU delirium to improve the quality of patient care and enhance the competence of nurses. With ICU delirium being fatal it is a matter of patient safety and getting the right treatment at the right time