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Special issue
This article is part of special issue:
Update on analgesia, sedation, restraint and delirium in the Critical Care Units
Edited by: María Acevedo. Hospital Universitario Puerta de Hierro Majadahonda, Spain
Last update: June 2025
More infoAbstract
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.
Keywords:
Delirium
Registered nurse
Intensive care units
Non-pharmacological interventions
Resumen
En las unidades de cuidados intensivos, y dada la naturaleza de la enfermedad crítica y las peculiaridades del entorno, es relativamente frecuente que los pacientes desarrollen un síndrome confusional agudo o delirio. La enfermera desempeña un papel fundamental dentro de sus funciones al realizar intervenciones destinadas a disminuir la incidencia de este proceso, que no deja de ser una complicación significativa al relacionarse con mayor tiempo de ventilación mecánica, estancias en UCI y hospitalarias más largas, mayor mortalidad, tanto intrahospitalaria como tras el alta y una mayor disfunción cognitiva a largo plazo. Por lo tanto, su participación es esencial para la prevención y tratamiento del delirio, especialmente a través de medidas no farmacológicas tales como el control del dolor, evitar la infra o la sobresedación, promover un sueño reparador y facilitando el acompañamiento familiar entre otras medidas. El objetivo de este artículo es proporcionar una actualización basada en la bibliografía, con 10 puntos clave centrados en las herramientas de detección y monitorización del delirio, así como en las medidas no farmacológicas para su prevención y tratamiento para que sirvan de guía de actuación y se incluyan en los planes de cuidados en el paciente crítico.
Palabras clave:
Delirio
Enfermera
Unidades Cuidados Intensivos
Intervenciones no farmacológicas
Article
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