ICU Delirium

According to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV delirium is defined as “a disturbance of consciousness and cognition that develops over a short period of time (hours to days) and fluctuates over time.”  Delirium is an all too common problem in the ICU and according to Girard, Pandharpande, & Ely (2008),  “Delirium occur[s] in up to 80% of the sickest intensive care unit (ICU) populations.”   Patients in the ICU share some common risk factors for developing ICU Delirium which, according to Girard, Pandharpande, & Ely (2008), include  “exposure to sedative and analgesic medications.” To help reduce the risk of a patient developing delirium, factors such as sedatives and analgesia can be closely monitored and titrated. Girard, Pandharpande, & Ely (2008), also suggest “that all ICU patients be monitored using a validated delirium assessment instrumentmay be modified to reduce risk.”  It is important to decrease the risk and the occurance of delirium in ICU patients because “delirium is now recognized to be a significant contributor to morbidity and mortality in the ICU…Patients with delirium have longer hospital stays and lower 6-month survival than do patients without delirium, and preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after after discharge” (Girard, Pandharpande, & Ely, 2008).  As nurses we should be aware of the signs and symptoms of ICU delirium and attempt to implement assessment tools to monitor for this complication.

Girard, T., Pandharipande, P., Ely, E.W. (2008). Delirium in the intensive care unit. Critical Care 12(3).