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"In patients admitted to the ICU, how does goal-directed light sedation compared to no current standards implemented affect the risk of patients developing ICU delirium?"
The Problem
High incidence of delirium in mechanically ventilated ICU patients.
Lack of standardized protocol for delirium management.
Reliance on deep sedation, leading to prolonged ICU stays and increased mortality rates.
Preventing the Incidence of Delirium in the Intensive Care Unit
Early Identification and Strategies to Prevent ICU Delirium
Justification for change
Improves daily function of the unit
The ability of staff to provide better care
Patients are less likely to experience adverse effects
Improves both patient and staff satisfactioneveryone wins
Implementation strategy
Plan: Protocol, train, and pilot
Do: Implement and document
Study: Analyze and identify
Act: Refine
Expected outcomes:
Anticipated Outcomes from Implementing Goal-Directed Light Sedation
Reduced incidence of ICU delirium
Shorter ICU stays and improved patient turnover
Improved staff competency and satisfaction
For additional reading:
1. Noguchi, A., kerman, E., Capuzzo, M., Inouye, S. K., Jones, C., Laerkner, E., ... & Balas, M. C. (2020). Factors related to memory absence and delusional memories in patients in intensive care units managed with light sedation. Intensive and Critical Care Nursing. https://www.sciencedirect.com/science/article/pii/S0964339720300331
2. Ceric, A., Holgersson, J., May, T., Skrifvars, M. B., Hstbacka, J., Saxena, M., ... & Nielsen, N. (2022). Level of sedation in critically ill adult patients: a protocol for a systematic review with meta-analysis and trial sequential analysis. BMJ open, 12(9), e061806. https://doi.org/10.1136/bmjopen-2022-061806
3. Dechant, T., Smith, L. & Chavez, J. (2023). Recognizing and Reducing Delirium in the Intensive Care Unit. Critical Care Nursing Quarterly, 46 (3), 277-281. https://doi.org/10.1097/CNQ.0000000000000465.
4. Ku, Y. L., Tang, M. H., Chen, S. M., Kuo, W. Y., & Huang, K. T. (2023). Delirium Care by Intensive Care Unit Nurses: Focus Group Studies in a Medical Center of Southern Taiwan. Dimensions of critical care nursing: DCCN, 42(5), 255262. https://doi.org/10.1097/DCC.0000000000000568
5. Palakshappa, J. A., & Hough, C. L. (2021). How We Prevent and Treat Delirium in the ICU. Chest, 160(4), 13261334. https://doi.org/10.1016/j.chest.2021.06.002
6. Sahawneh, F., Boss, L. (2021). Non-pharmacologic interventions for the prevention of delirium in the intensive care unit: An integrative review. Nursing in Critical Care, 26, 166175. https://doi.org/10.1111/nicc.12594
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