Preventing Delirium 301-2: Limit LOS, Leverage Others
Lesson Progress
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Limit prolonged ED LOS
Consider prioritization of high-risk patients for admission.
Encourage Family Presence
Re-orienting, comforting, ambulating, vision/hearing aids
Smithburger PL, et al. Crit Care Nurse. 2017;37(6):e1–e9
- Family members want to be involved with delirium care and prevention, but often are unsure what to do
- Families expressed interest in learning from nurses and providers how to participate in care and to help prevent delirium
Nassar Jr AP, et al. Crit Care Med. 2018;46(7):1175–1180
Flexible visiting policies:
- In ICUs, flexible visiting policies have been shown to reduce delirium and severity of anxiety symptoms as compared to restrictive visiting policies; it also has been shown to improve family members’ satisfaction.
- No RCT data yet; currently RCT underway in 40 ICUs in Brazil
Volunteer program to engage and orient at-risk individuals
Sanon M, et al. J Am Geriatr Soc. 2014;62(2):365–370.
- Geriatric‐focused volunteer program developed to help prevent avoidable complications such as delirium
- Adaptation of the volunteer aspect of the HELP program for the ED
- Bedside volunteer interventions include conversation, short activities, and reorientation
References
Nassar Jr AP, et al. Crit Care Med. 2018;46(7):1175–1180.
Sanon M, et al. J Am Geriatr Soc. 2014;62(2):365–370.
Smithburger PL, et al. Crit Care Nurse. 2017;37(6):e1–e9.
Abbreviations
ED, emergency department
HELP, Hospital Elder Life Program
ICU, intensive care units
LOS, length of stay
RCT, randomized controlled trial