10 key issues for prevention, monitoring and non-pharmacological treatment of delirium in critically ill patients

Olga Vallés-Fructuoso RN, MSc , Juan José Rodríguez-Mondéjar RN, MSc, PhD , David Alonso-Crespo RN, MSc , Gemma Robleda-Font RN, MSc, PhD , Candelas López-López RN, MSc, PhD , Diana Gil-Castillejos RN, MSc, PhD , María Acevedo-Nuevo RN, MSc, PhD
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Abstract

In intensive care units, due to critical illness nature and environment special characteristics, it is relatively common for admitted patients to develop acute confusional syndrome (ACS) or delirium. The nurse’s duties are to carry out interventions that reduce the presentation of this process, which is still an important complication as it is related to longer periods of mechanical ventilation, longer ICU and hospital stays, higher mortality; both in-hospital and after discharge and grater long term cognitive dysfunction. Therefore, nurses participation is essential to prevent and treat delirium, and more specifically in the autonomous part with non-pharmacological measures such as pain control, avoid under or oversedation, promoting restful sleep and facilitating family support among other measures. The objective is to carry out an update that describes 10 key points focused on the tools for detecting/monitoring delirium and non-pharmacological measures for its prevention and treatment. Based on the review of the literature, the 10 most common interventions are described to serve as an action plan to be included in the care plans of patients affected with delirium, providing quality care to prevent and/or treat delirium in critical patients.
危重症谵妄的预防、监测和非药物治疗的10个重点问题
在重症监护病房,由于重症的性质和环境的特殊性,入院患者出现急性精神错乱综合征(acute confusion syndrome, ACS)或谵妄是比较常见的。护士的职责是采取干预措施,减少这一过程的出现,这仍然是一个重要的并发症,因为它与机械通气时间更长、ICU和住院时间更长、死亡率更高有关;住院和出院后以及更严重的长期认知功能障碍。因此,护士的参与对于预防和治疗谵妄至关重要,更具体地说,在自主部分,采用非药物措施,如疼痛控制、避免镇静不足或过度、促进安宁睡眠和促进家庭支持等措施。目标是进行一次更新,描述了10个重点,重点是检测/监测谵妄的工具和预防和治疗谵妄的非药物措施。基于文献回顾,10种最常见的干预措施被描述为一个行动计划,包括在谵妄患者的护理计划中,为危重患者提供高质量的护理,以预防和/或治疗谵妄。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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