Confused, agitated patients. Extended ICU stays. Higher healthcare costs. These aren’t isolated incidents; they’re all potential consequences of a common condition – ICU delirium – a harsh reality for up to 80% of critically ill patients1. This acute change in mental state, accompanied by inattention and altered cognition, not only creates a stressful environment for patients but also silently erodes your hospital’s bottom line.
However, the good news is that hospitals can play a crucial role in preventing and managing ICU delirium. By implementing proactive measures and innovative tools, such as an ICU diary, you can ensure a better patient experience, improve clinical outcomes, and ultimately, strengthen your hospital’s financial standing. This article dives deep into the evidence-based strategies and resources available to combat ICU delirium.
While the human cost of ICU delirium is significant for patients and their families, the impact on hospitals is equally concerning.
The true cost of ICU delirium is of course borne by the patients themselves:
The impact ICU delirium has on patients, hospitals and critical care staff led to the development of preventative and management strategies outlined below.
ICU delirium is not an inevitable consequence of critical illness. Hospitals can significantly reduce its incidence by implementing the following strategies:
This evidence-based protocol reduces delirium and coma days by 25% to 50%8. It outlines six key areas for proactive management and addresses various factors that can contribute to delirium, promoting a more alert and oriented state for patients.
Maintaining appropriate brightness levels, and a quiet environment with a regular sleep-wake cycle helps promote orientation and reduce sensory overload. 9
Simple activities like word puzzles or picture recognition can help stimulate cognitive function and prevent mental decline.10
Encourage early physical activity and exercise to improve circulation, oxygenation, and cognitive function. This can involve simple activities like sitting up in bed or assisted walking.11
Consider incorporating music therapy based on patient preferences. Soothing music can promote relaxation and reduce agitation in some patients.12
Closely monitor blood oxygen saturation levels and ensure they remain above 90% to prevent hypoxia, which can contribute to delirium.
Identifying and treating underlying medical conditions such as infections or electrolyte imbalances that can contribute to delirium.
Digital diaries offer benefits for both parents and infants in the NICU/PICU environment, as well as hospitals and ICUs through:
Research has shown that involving parents in their child’s care through FCC approaches can significantly reduce stress and feelings of helplessness.6Digital diaries provide a platform for parents to actively participate in their child’s care journey, document their observations and questions, and collaborate more effectively with the care team. This empowerment contributes to a more positive and engaged experience for parents during a challenging time.
Studies have demonstrated the positive impact of FCC on infant outcomes.7By reducing separation anxiety, digital diaries can contribute to the overall well-being of NICU/PICU families and that has an impact on the patients as well. Parents can use the diary to express love and encouragement for their child, fostering a sense of connection despite physical separation.
The early stages of parent-infant bonding are crucial for long-term development. One of the most stressful aspects of NICU for parents is the was the alteration of the parental bond.8 Digital diaries can be a powerful tool for promoting this vital bond. Parents can record their thoughts, feelings, and experiences alongside pictures and videos of their child, creating a cherished record of their journey together. This not only helps parents stay connected during separation but also provides a valuable resource for strengthening the bond after discharge.
Both parents can contribute to the diary and share their thoughts and feelings through the journaling process. Since both parents have access to these entries, they can read each other’s contributions and get insight into where they are in the trauma process. This type of indirect communication between parents helps increase understanding.
The mother of a NICU baby is a parent but also a patient. Frequently, the parental role takes over and mothers put aside the fact that they’ve just gone through giving birth and also need to take care of their physical and mental health. Postpartum depression is more common among mothers of infants admitted to the neonatal intensive care unit (NICU) compared to the general population. Studies have found the incidence of PPD of up to 40% in this group9. Having an outlet to express emotions and process this traumatic situation might help mothers take care of their psychological health while their baby is in the NICU. More research is required to confirm that diaries have this impact.
While prevention is key, some patients will still develop ICU delirium. In such cases, it’s crucial to implement effective management strategies to minimize the impact on patients and support recovery. Here’s what hospitals and ICU staff can do:
While the strategies mentioned above form the core of ICU delirium management, innovative tools like Post-ICU Digital Diary can offer additional support. This digital diary is made specifically for patients recovering from critical illness and has features that can potentially benefit delirium management in several ways:
Important Note: Post-ICU diary is not a replacement for the core management strategies outlined earlier. However, its features can complement these strategies and offer valuable tools for supporting patients and families while potentially aiding in the early detection and management of ICU delirium.
Hospitals have a critical role to play in preventing ICU delirium. By adopting evidence-based strategies like the ABCDEF Bundle and considering innovative tools like Post-ICU digital diary, healthcare providers can create a culture of delirium prevention, optimize patient care, and ensure a more successful outcome for everyone involved.
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