Clocks on the intensive care unit: A quality improvement initiative to improve patient orientation.

Abstract

Prevention and management of delirium is important for patients on intensive care units (ICU). National Guidelines recommend visible 24-hour clocks for ICU patients. Multi-modal approaches including improved orientation help prevent delirium, but literature on specific impacts of clocks on orientation in ICU patients is limited. This quality improvement project in a tertiary ICU introduced clocks at each bedspace and assessed impact on patient orientation. Proportion of patients orientated to time improved from 45% initially, to 70% post-implementation, then 94% following clock repositioning. Feedback was positive. Clocks are effective in aiding re-orientation which may support delirium prevention and management in ICUs.