Ambient lighting |
Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
|
To adjust ambient lighting |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To adjust ambient lighting to promote sleep |
Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
|
To expose the patient to natural light during the day and minimize exposure to artificial light at night |
El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To minimize excess light stimuli using devices such as an eye mask |
Meagher (2001) Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To guide the patient in the environment |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To modify the intensity of the lighting to indicate the day/night change |
Environmental noise reduction |
Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
|
To reduce environmental noise |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To reduce environmental noise to promote sleep |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
|
To incorporate a protocol that introduces moments of silence twice a day at specific times; to stop using unnecessary monitors or equipment; to minimize phone usage and conversations around the patient |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To minimize excess auditory stimuli using devices such as earplugs |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To control noise levels, based on <45 decibels during the day and <20 decibels at night |
Optimization of ambient temperature |
Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To adjust the room temperature |
Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
|
To address specific causes that generate stress, such as excessive heat/cold |
Strategies for temporal and spatial (re) orientation |
Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To implement (re) orientation strategies |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Kalish et al. (2014Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158.), Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Rains & Chee (2017),Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
, van Velthuijsen et al. (2018van Velthuijsen, E. L., Zwakhalen, S., Mulder, W. J., Verhey, F., & Kempen, G. (2018). Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice. International Journal of Geriatric Psychiatry, 33(11), 1521-1529. http://dx.doi.org/10.1002/gps.4690. http://dx.doi.org/10.1002/gps.4690...
) |
To provide devices in the room for temporal reorientation, in visible places and with clear information, such as: clocks, calendars, guidance materials, reminders and tables with the day's schedule, daily news published in the media, the patient's diary life, talking about family events information leaflets and radio |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To guide the patient spatially |
El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
|
To guide the patient using daily reminders |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To frequently provide information to guide the patient about the reason for their hospitalization |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To encourage the participation of family and friends to reorient the patient |
Organization of the environment |
Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
|
To favor the environment with familiar and personalized objects |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Salawu et al. (2009) Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To prioritize the patient to stay in individual rooms |
Establishing the patient's relationship with the staff |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To make available, in a visible place, tables with the names of the employees that the patient has contact with |
Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To minimize changes in the nursing team |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To establish a referral professional for patient care |
Ensuring patient safety |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
|
To remove or monitor access to dangerous items, line the bed rails, lower the level of the beds as much as possible and place rubberized rugs on the floor |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To allow adequate space between beds, removing unnecessary objects |
Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To add a card access door and have low hospital beds |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To put the patient's bed in the team's field of vision; to minimize the use of devices that can reduce patient mobility |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Quiroz, Araya & Fuentes (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To adapt the bathroom with the installation of a light sensor; having beds with high protection at the headboards |
Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To assess patient safety and avoid using equipment that could injure themselves or others |
El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Hughes et al. (2012)Hughes, C. G., Brummel, N. E., Vasilevskis, E. E., Girard, T. D., & Pandharipande, P. P. (2012). Future directions of delirium research and management. Best Practice & Research Clinical Anaesthesiology, 26(3), 395-405. http://dx.doi.org/10.1016/j.bpa.2012.08.004. http://dx.doi.org/10.1016/j.bpa.2012.08....
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To remove or fix potentially harmful devices, such as: lines, catheters, Foleys, nasogastric tubes, or intravenous access connectors |
Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To monitor patients at risk for self-mutilation |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Chevrolet & Jolliet (2007),Chevrolet, J. C., & Jolliet, P. (2007). Clinical review: agitation and delirium in the critically ill-significance and management. Critical Care, 11(3), 214. http://dx.doi.org/10.1186/cc5787. http://dx.doi.org/10.1186/cc5787...
El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
, van Velthuijsen et al. (2018)van Velthuijsen, E. L., Zwakhalen, S., Mulder, W. J., Verhey, F., & Kempen, G. (2018). Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice. International Journal of Geriatric Psychiatry, 33(11), 1521-1529. http://dx.doi.org/10.1002/gps.4690. http://dx.doi.org/10.1002/gps.4690...
|
To reduce the use of physical restrictions or consider its use only in case of very agitated patients who pose a risk to themselves or when other means of treating delirium have not been enough. |
Correction of sensory deficits related to vision or hearing |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Kalish et al. (2014),Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158.Meagher (2001),Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To provide individualized visual devices, such as: glasses, contact lenses, magnifiers, and magnifying glasses |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To provide individualized hearing aids, such as amplification devices |
Oral health promotion |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To provide dentures |
Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
|
To encourage oral hygiene |
Pain control |
Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To control the pain |
Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
|
To assess and manage pain, based on a multifactorial approach |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To palpate the skin, bones, and joints to identify tender points; to check for the presence of chronic pain; to perform adequate analgesia; in case of acute injury, cryotherapy, elevation, or immobilization, if necessary |
Prevention of other clinical conditions associated with the hospitalization process |
Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To assess swallowing in a supervised and assisted manner |
Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
|
To manage hypoxia with a trained team for its prevention |
Hughes et al. (2012)Hughes, C. G., Brummel, N. E., Vasilevskis, E. E., Girard, T. D., & Pandharipande, P. P. (2012). Future directions of delirium research and management. Best Practice & Research Clinical Anaesthesiology, 26(3), 395-405. http://dx.doi.org/10.1016/j.bpa.2012.08.004. http://dx.doi.org/10.1016/j.bpa.2012.08....
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To maintain adequate hydration |
Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
|
To monitor the patient's electrolyte balance |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
|
To monitor fluid intake and rehydrate the patient with salt-containing drinks, such as soups and sports drinks |
Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To prevent hypovolemia |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To monitor renal biomarkers (blood urea nitrogen and creatinine) and, if necessary, to administer isotonic intravenous fluid |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
|
To maintain adequate nutrition |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To check the bladder with ultrasound and, if necessary, empty it with a straight urinary catheter |
Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
|
To avoid incontinence and urinary retention |
Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
|
To prevent constipation |
Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To check the hygiene of the patient's underwear; rectal examination if necessary; to consider the need for disimpaction; to restrict the use of medications that cause constipation |
Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To prevent sensory deprivation |
Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To treat underlying systemic conditions |
Proper positioning on the bed |
Chevrolet & Jolliet (2007)Chevrolet, J. C., & Jolliet, P. (2007). Clinical review: agitation and delirium in the critically ill-significance and management. Critical Care, 11(3), 214. http://dx.doi.org/10.1186/cc5787. http://dx.doi.org/10.1186/cc5787...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
|
To properly put the patient on the bed, avoiding: pressure ulcers or a sensation of pain in the bladder |
Early mobility and exercise |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Hipp & Ely (2012)Hipp, D. M., & Ely, E. W. (2012). Pharmacological and nonpharmacological management of delirium in critically ill patients. Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics, 9(1), 158-175. http://dx.doi.org/10.1007/s13311-011-0102-9. http://dx.doi.org/10.1007/s13311-011-010...
, Hughes et al. (2012)Hughes, C. G., Brummel, N. E., Vasilevskis, E. E., Girard, T. D., & Pandharipande, P. P. (2012). Future directions of delirium research and management. Best Practice & Research Clinical Anaesthesiology, 26(3), 395-405. http://dx.doi.org/10.1016/j.bpa.2012.08.004. http://dx.doi.org/10.1016/j.bpa.2012.08....
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Robinson & Eiseman (2008),Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To apply early mobilization exercises adapted to the capabilities of each patient, favoring daily walking, range of motion, and prevention of complications related to immobilization |
Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
|
To apply combined passive range of motion (PROM) exercises, active physiotherapy, ambulation, cycle ergometry, and neuromuscular electrical stimulation |
Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
|
To mobilize the seated patient, use a Stryker chair for transfers and motomed to perform passive and active exercises as soon as the patient is stable |
Assistive Technology |
Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To use walking aids, such as a walker and cane, to assist in early mobilization |
Sleep promotion strategies |
Hipp & Ely (2012)Hipp, D. M., & Ely, E. W. (2012). Pharmacological and nonpharmacological management of delirium in critically ill patients. Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics, 9(1), 158-175. http://dx.doi.org/10.1007/s13311-011-0102-9. http://dx.doi.org/10.1007/s13311-011-010...
, Hughes et al. (2012)Hughes, C. G., Brummel, N. E., Vasilevskis, E. E., Girard, T. D., & Pandharipande, P. P. (2012). Future directions of delirium research and management. Best Practice & Research Clinical Anaesthesiology, 26(3), 395-405. http://dx.doi.org/10.1016/j.bpa.2012.08.004. http://dx.doi.org/10.1016/j.bpa.2012.08....
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Robinson & Eiseman (2008)Robinson, T. N., & Eiseman, B. (2008). Postoperative delirium in theelderly: diagnosis and management. Clinical Interventions in Aging, 3(2), 351-355. http://dx.doi.org/10.2147/CIA.S2759. http://dx.doi.org/10.2147/CIA.S2759...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To encourage peaceful and uninterrupted sleep |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
|
To avoid the administration of medications at dawn, close doors and keep the lights off during this period |
Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
|
To facilitate sleep through the use of devices such as earplugs and eye masks |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To encourage a pleasant evening environment through: massages, relaxing music, and drinking warm or hot drinks |
van Velthuijsen et al. (2018) |
To involve the family to spend the night with the patient, bringing pillows and sheets from their home to make the hospital environment more comfortable |
Reduced use of pharmacological strategies |
Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
|
To reduce daily sedation, adapting to their unique needs |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To reduce the use of drugs that can trigger delirium. Therefore, considering the interaction with other drugs, such as: psychoactive, anticholinergics, and benzodiazepines |
Patient participation |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
|
To involve the patient when filling out their hospital documentation |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To encourage the patient to provide feedback on their pain, aiming to promote self-care and participation in treatment |
Family participation and empowerment |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Morandi et al. (2019)Morandi, A., Pozzi, C., Milisen, K., Hobbelen, H., Bottomley, J. M., Lanzoni, A., Tatzer, V. C., Carpena, M. G., Cherubini, A., Ranhoff, A., MacLullich, A. J., Teodorczuk, A., & Bellelli, G. (2019). An interdisciplinary statement scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT). BMC Geriatrics, 19(1), 253. http://dx.doi.org/10.1186/s12877-019-1264-2. http://dx.doi.org/10.1186/s12877-019-126...
|
To involve and empower families, to encourage their presence and prolonged visits; having a family support team |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To encourage family members and friends to assist the patient in communicating and can calm, help, protect, support, and advocate for the patient |
Health education |
Chevrolet & Jolliet (2007)Chevrolet, J. C., & Jolliet, P. (2007). Clinical review: agitation and delirium in the critically ill-significance and management. Critical Care, 11(3), 214. http://dx.doi.org/10.1186/cc5787. http://dx.doi.org/10.1186/cc5787...
; El Majzoub et al. (2019)El Majzoub, I., Abunafeesa, H., Cheaito, R., Ali Cheaito, M., & Elsayem, A. F. (2019). Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine, 8(5), 728-739. http://dx.doi.org/10.21037/apm.2019.09.14. http://dx.doi.org/10.21037/apm.2019.09.1...
, Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To offer health education to family members and caregivers, either verbally or written about: prevention, identification, and treatment of delirium. To do so, using guidelines in leaflets and booklets; and providing clear, complete, and objective explanations about treatment options, how to deal with the patient with delirium, and how to provide him with emotional support |
Álvarez et al. (2012)Álvarez, E., Garrido, M., González, F., Guzmán, E., Donoso, T., Gallegos, S., Vergara, S., Aranda, R., Prieto, S., Briceño, C., Tobar, E., Alzamora, C., Bolvarán, C., Concha, C., Valencia, F., & Villalobos, F. (2012). Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico: ensayo clínico randomizado: resultados preliminares. Revista Chilena de Terapia Ocupacional, 12(1), 45-59. http://dx.doi.org/10.5354/0719-5346.2012.22051. http://dx.doi.org/10.5354/0719-5346.2012...
, Finucane et al. (2017)Finucane, A. M., Lugton, J., Kennedy, C., & Spiller, J. A. (2017). The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psycho-Oncology, 26(3), 291-300. http://dx.doi.org/10.1002/pon.4140. http://dx.doi.org/10.1002/pon.4140...
, Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To offer health education to professionals on the causes of delirium in older people, their types, risk factors, prodromal symptoms; and the roles of each team member in preventing this condition |
Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
, van Velthuijsen et al. (2018)van Velthuijsen, E. L., Zwakhalen, S., Mulder, W. J., Verhey, F., & Kempen, G. (2018). Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice. International Journal of Geriatric Psychiatry, 33(11), 1521-1529. http://dx.doi.org/10.1002/gps.4690. http://dx.doi.org/10.1002/gps.4690...
|
To specialize the team regarding specific treatments and interventions in delirium |
Psychoeducational interventions to reduce anxiety |
Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To apply psychoeducational interventions to reduce anxiety and reframe delirium experiences |
Communication between staff and patient |
Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Cavallazzi et al. (2012)Cavallazzi, R., Saad, M., & Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of Intensive Care, 2(1), 2-11. http://dx.doi.org/10.1186/2110-5820-2-49. http://dx.doi.org/10.1186/2110-5820-2-49...
, Rosen et al. (2015)Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N. (2015). Assessment and management of delirium in older adults in the emergency department. Advanced Emergency Nursing Journal, 37(3), 183-E3. http://dx.doi.org/10.1097/TME.0000000000000066. http://dx.doi.org/10.1097/TME.0000000000...
|
To improve communication between staff and patient by: identifying each time they meet the patient, repeatedly offering verbal reminders, not using extremely technical language, addressing the patient personally with objective instructions |
Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Pozzi et al. (2020)Pozzi, C., Tatzer, V. C., Álvarez, E. A., Lanzoni, A., & Graff, M. J. L. (2020). The applicability and feasibility of occupational therapy in delirium care. European Geriatric Medicine, 11(2), 209-216. http://dx.doi.org/10.1007/s41999-020-00308-z. http://dx.doi.org/10.1007/s41999-020-003...
|
To avoid confrontations with the patient, to act calmly and repeat instructions whenever necessary |
Meagher (2001)Meagher, D. J. (2001). Delirium: optimising management. BMJ, 322(7279), 144-149. http://dx.doi.org/10.1136/bmj.322.7279.144. http://dx.doi.org/10.1136/bmj.322.7279.1...
|
To consider whether an interpreter is needed in the case of sensory impairments |
Evaluation and monitoring of the patient by the team |
Hipp & Ely (2012)Hipp, D. M., & Ely, E. W. (2012). Pharmacological and nonpharmacological management of delirium in critically ill patients. Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics, 9(1), 158-175. http://dx.doi.org/10.1007/s13311-011-0102-9. http://dx.doi.org/10.1007/s13311-011-010...
, Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To daily monitor the patient, from admission to discharge, with attention to aspects such as: assessing vital signs, electrolyte fluid status, oxygen saturation, respiratory and cardiovascular status, possible skin infections, neurological deficit |
van Velthuijsen et al. (2018) van Velthuijsen, E. L., Zwakhalen, S., Mulder, W. J., Verhey, F., & Kempen, G. (2018). Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice. International Journal of Geriatric Psychiatry, 33(11), 1521-1529. http://dx.doi.org/10.1002/gps.4690. http://dx.doi.org/10.1002/gps.4690...
|
To apply Delirium Observation Screening, morning, afternoon, and evening, to assess and monitor delirium |
Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
|
To perform a cognitive assessment |
Cognitive stimulation |
Banh (2012),Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
Hughes et al. (2012)Hughes, C. G., Brummel, N. E., Vasilevskis, E. E., Girard, T. D., & Pandharipande, P. P. (2012). Future directions of delirium research and management. Best Practice & Research Clinical Anaesthesiology, 26(3), 395-405. http://dx.doi.org/10.1016/j.bpa.2012.08.004. http://dx.doi.org/10.1016/j.bpa.2012.08....
, Kolanowski et al. (2016)Kolanowski, A., Fick, D., Litaker, M., Mulhall, P., Clare, L., Hill, N., Mogle, J., Boustani, M., Gill, D., & Yevchak-Sillner, A. (2016). Effect of cognitively stimulating activities on symptom management of delirium superimposed on dementia: a randomized controlled trial. Journal of the American Geriatrics Society, 64(12), 2424-2432. http://dx.doi.org/10.1111/jgs.14511. http://dx.doi.org/10.1111/jgs.14511...
, Irwin et al. (2013)Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013). Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. Journal of Palliative Medicine, 16(4), 423-435. http://dx.doi.org/10.1089/jpm.2012.0319. http://dx.doi.org/10.1089/jpm.2012.0319...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To offer cognitively stimulating activities, in an early, regular, and individualized way |
Routine organization |
Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
|
To implement a routine of daytime activities, organized into schedules, including functional tasks and rest periods |
Music Therapy |
Banh (2012), Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To use music therapy |
Chromotherapy |
Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
, Salawu et al. (2009)Salawu, F. K., Danburam, A., & Ogualili, P. (2009). Delirium: issues in diagnosis and management. Annals of African Medicine, 8(3), 139-146. http://dx.doi.org/10.4103/1596-3519.57235. http://dx.doi.org/10.4103/1596-3519.5723...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To use light therapy |
Relaxing therapies |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To apply relaxation techniques and massage therapy to help improve agitation and sleep |
Alternative and complementary medicine |
Banh (2012)Banh, H. L. (2012). Management of delirium in adult critically ill patients: an overview. Journal of Pharmacy & Pharmaceutical Sciences, 15(4), 499-509. http://dx.doi.org/10.18433/J3PK69. http://dx.doi.org/10.18433/J3PK69...
|
To use practices such as: Chinese medicine techniques, Ayurveda, homeopathy/naturopathic medicine, animal-assisted therapy, art therapy, guided imagery, meditation, music therapy, prayer, acupressure, chiropractic/manipulative therapy and massage, use of food supplements and products based on plants, Qigong, reiki, therapeutic touch and therapies based on bioelectromagnetic |
ABCDEF package |
Hipp & Ely (2012)Hipp, D. M., & Ely, E. W. (2012). Pharmacological and nonpharmacological management of delirium in critically ill patients. Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics, 9(1), 158-175. http://dx.doi.org/10.1007/s13311-011-0102-9. http://dx.doi.org/10.1007/s13311-011-010...
, Ibrahim et al. (2018)Ibrahim, K., McCarthy, C. P., McCarthy, K. J., Brown, C. H., Needham, D. M., Januzzi Junior, J. L., & McEvoy, J. W. (2018). Delirium in the Cardiac Intensive Care Unit. Journal of the American Heart Association, 7(4), e008568. http://dx.doi.org/10.1161/JAHA.118.008568. http://dx.doi.org/10.1161/JAHA.118.00856...
, Morandi et al. (2017)Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I. F., Amare, D., Azoulay, E., Bellelli, G., Csomos, A., Fan, E., Fagoni, N., Girard, T. D., Heras La Calle, G., Inoue, S., Lim, C. M., Kaps, R., Kotfis, K., Koh, Y., Misango, D., Pandharipande, P. P., Permpikul, C., Cheng Tan, C., Wang, D. X., Sharshar, T., Shehabi, Y., Skrobik, Y., Singh, J. M., Slooter, A., Smith, M., Tsuruta, R., & Latronico, N. (2017). Worldwide survey of the “assessing pain, both spontaneous awakening and breathing trials, choice of drugs, delirium monitoring/management, early exercise/mobility, and family empowerment” (abcdef) bundle. Critical Care Medicine, 45(11), e1111-e1122. http://dx.doi.org/10.1097/CCM.0000000000002640. http://dx.doi.org/10.1097/CCM.0000000000...
, Rains & Chee (2017)Rains, J., & Chee, N. (2017). The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care. The Journal of the Intensive Care Society, 18(4), 318-322. http://dx.doi.org/10.1177/1751143717720589. http://dx.doi.org/10.1177/17511437177205...
, Tobar et al. (2017)Tobar, E., Alvarez, E., & Garrido, M. (2017). Cognitive stimulation and occupational therapy for delirium prevention. Revista Brasileira de Terapia Intensiva, 29(2), 48-252. http://dx.doi.org/10.5935/0103-507X.20170034. http://dx.doi.org/10.5935/0103-507X.2017...
|
To implement the strategies that make up the ABCDEF package, which refer, respectively, to the “spontaneously waking/waking test”, “daily spontaneous breathing tests”, to the appropriate choice of sedatives, to the removal of the patient from mechanical ventilation and the ICU as soon as possible, to early mobilization to reduce delirium and improve long-term cognitive outcomes and carry out interventions aimed at involving and empowering the family |
Life Program for Old People at the Hospital (HELP) |
Hipp & Ely (2012)Hipp, D. M., & Ely, E. W. (2012). Pharmacological and nonpharmacological management of delirium in critically ill patients. Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics, 9(1), 158-175. http://dx.doi.org/10.1007/s13311-011-0102-9. http://dx.doi.org/10.1007/s13311-011-010...
, Kalish et al. (2014)Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: evaluation and management. American Family Physician, 90(3), 150-158., Oh-Park et al. (2018)Oh-Park, M., Chen, P., Romel-Nichols, V., Hreha, K., Boukrina, O., & Barrett, A. M. (2018). Delirium screening and management in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation, 97(10), 754-762. http://dx.doi.org/10.1097/PHM.0000000000000962. http://dx.doi.org/10.1097/PHM.0000000000...
, Quiroz et al. (2014)Quiroz, O. T., Araya, O. E., & Fuentes, G. P. (2014). Delirium: actualización en manejo no farmacológico. Revista Chilena de Neuro-psiquiatría, 52(4), 288-297. http://dx.doi.org/10.4067/S0717-92272014000400007. http://dx.doi.org/10.4067/S0717-92272014...
|
To reorient the patient with wall calendars, pictures with family photos visits from friends and family; to promote early mobilization; to favor a peaceful evening atmosphere with the consumption of hot drinks and pleasant music; to reduce light and environmental noise; to avoid unnecessary controls, and maintain adequate hydration and nutrition |