Delirium

Delirium

• Another name for delirium is acute confusion.
• Untreated delirium can lead to potential consequences such as increased morbidity, mortality, and healthcare costs.

Prevalence and Impact

• Delirium affects approximately 80% of patients in intensive care units.
• Delirium increases in-hospital mortality rates.
• It is associated with increased medical care costs.

Differential Diagnosis

• Delirium can sometimes be mistaken for dementia.
• The presence of an acute onset and fluctuating course assists in distinguishing between dementia and delirium.

Risk Factors

• Modifiable risk factors for delirium include sleep deprivation, immobility, and medication use.
• Nonmodifiable risk factors for delirium include advanced age, pre-existing cognitive impairment, and history of dementia.

Vulnerable Populations

• Older adults are particularly vulnerable to acute confusion.

Management and Prevention

• The most effective approach for managing delirium is a multimodal strategy that includes non-pharmacological and pharmacological interventions.
• All critically ill patients should receive delirium screening.
• Unrecognized delirium can lead to increased morbidity, mortality, and healthcare costs.

Medication Management

• Nonessential medications should be discontinued or reduced for a patient with delirium.

Patient Safety

• Managing patient safety is crucial for delirium patients, as they are at risk of falls, injuries, and other adverse events.

Nursing Role

• The nurse plays a crucial role in managing delirium through ongoing mental status assessments, non-pharmacological interventions, and coordination of care.

Dementia

• Alzheimer's disease is the most common type of dementia in older adults.
• Dementia affects a person's ability to function by impairing cognitive, functional, and behavioral abilities.
• The key recommendation for managing dementia is to focus on individualized, person-centered care.

Family Involvement

• The family plays a crucial role in therapeutic activities for delirium patients, such as providing emotional support and assisting with care.

Evidence-Based Practice

• Research evidence supports the use of multicomponent interventions, such as early mobility, cognitive stimulation, and sleep promotion, to reduce delirium in critically ill patients.