Iluminação ambiental |
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...
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Adequar a iluminação ambiental |
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...
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Adequar a iluminação ambiental para favorecer o sono |
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...
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Expor o paciente à luz natural durante o dia e minimizar a exposição à luz artificial durante a noite |
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...
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Minimizar o excesso de estímulos luminosos usando dispositivos como máscara ocular |
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...
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Orientar o paciente no ambiente |
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...
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Modificar a intensidade da iluminação para indicar a mudança dia/noite |
Redução de ruído ambiental |
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...
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Reduzir os ruídos ambientais |
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...
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Reduzir os ruídos ambientais para favorecer o sono |
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...
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Incorporar um protocolo que instaure momentos de silêncio duas vezes ao dia em horários específicos; interromper o uso de monitores ou equipamentos desnecessários; minimizar o uso do telefone e conversas em torno do paciente |
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...
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Minimizar o excesso de estímulos auditivos usando dispositivos como tampões auriculares |
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...
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Controlar os níveis de ruído, tendo como base <45 decibéis durante o dia e <20 decibéis durante a noite |
Otimização da temperatura do ambiente |
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...
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Adequar a temperatura do ambiente |
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...
|
Abordar causas específicas que geram estresse, como por exemplo excesso de calor/frio |
Estratégias de (re)orientação temporal e espacial |
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...
|
Implementar estratégias de (re)orientação |
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. (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...
, 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. (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...
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Disponibilizar no quarto dispositivos de reorientação temporal, em locais visíveis e com informações claras, como: relógios, calendários, materiais de orientação, lembretes e quadros com a programação do dia, notícias diárias veiculadas na mídia, diário pessoal do paciente, falar sobre eventos familiares próximos, folhetos informativos e rádio |
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...
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Orientar o paciente espacialmente |
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...
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Orientar o paciente com uso de lembretes diários |
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...
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Fornecer frequentemente informações que orientem o paciente acerca do motivo de sua hospitalização |
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...
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Estimular a participação da família e amigos visando à reorientação do paciente |
Organização do ambiente |
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...
|
Favorecer que o ambiente tenha objetos familiares e personalizados |
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. (2009Salawu, 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...
) |
Priorizar que o paciente fique em quartos individuais |
Estabelecimento de relação do paciente com a equipe de funcionários |
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...
|
Disponibilizar, em local visível, quadros com os nomes dos funcionários que o paciente tem contato |
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...
|
Minimizar mudanças na equipe de enfermagem |
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...
|
Estabelecer profissional de referência para atendimento ao paciente |
Garantia da segurança do paciente |
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...
|
Remover ou monitorar o acesso a itens perigosos, forrar as grades do leito, abaixar o nível das camas o máximo possível e colocar tapetes emborrachados no chão |
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...
|
Permitir espaço adequado entre as camas, retirando objetos desnecessários |
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...
|
Adicionar uma porta de acesso por cartão e ter camas hospitalares baixas |
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...
|
Posicionar o leito do paciente no campo de visão da equipe; minimizar o uso de dispositivos que possam reduzir a mobilidade do paciente |
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...
|
Adequar o banheiro com a instalação de sensor de luz; ter leitos com proteção alta nas cabeceiras |
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...
|
Avaliar a segurança do paciente e evitar o uso de equipamentos que ele possa ferir a si próprio ou aos outros |
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...
|
Retirar ou fixar dispositivos potencialmente prejudiciais, como: linhas, cateteres, foleys, tubos nasogástricos ou conectores de acesso intravenoso |
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...
|
Monitorar pacientes que apresentam risco de automutilação |
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...
|
Reduzir o uso de restrições físicas ou considerar seu uso somente em caso de pacientes muito agitados que representem risco para si próprios ou quando outros meios de tratamento do delirium não tenham sido suficiente. |
Correção de deficit sensoriais relacionados à visão ou audição |
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), 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...
|
Disponibilizar aparelhos visuais individualizados, como: óculos, lentes de contato, lupas e lentes de aumento |
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...
|
Disponibilizar aparelhos auditivos individualizados, como dispositivos de amplificação |
Promoção da saúde bucal |
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...
|
Disponibilizar dentaduras |
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...
|
Favorecer a higiene bucal |
Controle da dor |
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...
|
Controlar a dor |
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...
|
Avaliar e gerenciar a dor, com base em uma abordagem multifatorial |
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...
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Realizar palpação na pele, ossos e articulações para identificar pontos dolorosos; verificar a presença de dor crônica; realizar analgesia adequada; em caso de lesão aguda, fazer crioterapia, elevação ou imobilização, se necessário |
Prevenção de outros quadros clínicos associados ao processo de hospitalização |
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...
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Avaliar a deglutição de forma supervisionada e assistida |
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...
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Gerenciar a hipóxia contando com uma equipe capacitada para sua prevenção |
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...
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Manter a hidratação adequada |
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...
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Monitorar o equilíbrio dos eletrólitos do paciente |
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...
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Monitorar a ingestão de líquidos e reidratar o paciente com bebidas que contenham sal, como sopas e bebidas esportivas |
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...
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Prevenir a hipovolemia |
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...
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Monitorar os biomarcadores renais (nitrogênio uréico sanguíneo e creatinina) e, caso necessário, administrar líquido intravenoso isotônico |
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...
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Manter uma nutrição adequada |
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...
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Verificar a bexiga com ultrassom e, se necessário, esvaziá-la com um cateter urinário reto |
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...
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Evitar a incontinência e retenção urinária |
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...
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Prevenir a constipação |
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...
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Verificar a higiene das roupas íntimas do paciente; fazer exame retal se necessário; considerar a necessidade de desimpactação; restringir o uso de medicamentos que causam constipação |
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...
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Prevenir privações sensoriais |
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...
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Tratar as condições sistêmicas subjacentes |
Posicionamento adequado no leito |
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...
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Posicionar o paciente adequadamente no leito, evitando: úlceras por pressão ou sensação de dor na bexiga |
Mobilidade e exercício precoces |
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...
|
Aplicar exercícios de mobilização precoce adaptados às capacidades de cada paciente, favorecendo a deambulação diária, amplitude de movimento e prevenção de complicações relacionadas à imobilização |
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...
|
Aplicar exercícios com amplitude de movimento passivo combinado (PROM), fisioterapia ativa, deambulação, cicloergometria e estimulação elétrica neuromuscular |
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...
|
Mobilizar o paciente sentado, utilizar uma cadeira stryker para transferências e motomed para a realização de exercícios passivos e ativos assim que o paciente se mostrar estável |
Tecnologia Assistiva |
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...
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Utilizar dispositivos de auxílio à marcha, como andador e bengala, para auxiliar na realização de mobilizações precoces |
Estratégias de promoção do sono |
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...
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Favorecer um sono tranquilo e ininterrupto |
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...
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Evitar a administração de medicamentos de madrugada, fechar portas e manter as luzes apagadas neste período |
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...
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Facilitar o sono por meio do uso de dispositivos, como: tampões de ouvido e máscaras oculares |
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...
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Favorecer um ambiente noturno agradável por meio de: massagens, músicas relaxantes e ingestão de bebidas mornas ou quentes |
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...
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Envolver a família para passar a noite com o paciente, trazendo travesseiros e lençóis de sua casa para tornar o ambiente hospitalar mais confortável |
Redução do uso de estratégias farmacológicas |
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...
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Reduzir as sedações diárias, adequando às necessidades singulares |
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...
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Reduzir o uso de drogas que podem desencadear delirium. Para tanto, levar em consideração a interação com outros medicamentos, como: psicoativos, anticolinérgicos e benzodiazepínicos |
Participação do paciente |
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...
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Envolver o paciente no momento de preenchimento de sua documentação hospitalar |
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...
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Incentivar que o paciente dê feedbacks sobre sua dor, visando promover o autocuidado e a participação no tratamento |
Participação e empoderamento da família |
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...
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Envolver e empoderar as famílias, incentivar sua presença e visitas prolongadas; ter uma equipe de apoio aos familiares |
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...
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Estimular que os membros da família e amigos auxiliem o paciente a se comunicar e possam acalmar, ajudar, proteger, apoiar e advogar pelo paciente |
Educação em saúde |
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...
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Oferecer educação em saúde aos familiares e cuidadores, de forma verbal ou escrita sobre: prevenção, identificação e tratamento do delirium. Para tanto, fazer uso de orientações em folhetos e livretos; e fornecer explicações claras, completas e objetivas sobre as opções de tratamento, como lidar com o paciente com delirium e como lhe fornecer apoio emocional |
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...
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Oferecer educação em saúde aos profissionais sobre as causas de delirium em idosos, seus tipos, fatores de risco, sintomas prodrômicos; além das funções de cada membro da equipe na prevenção desta condição |
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...
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Especializar a equipe a respeito dos tratamentos e intervenções específicas no delirium |
Intervenções psicoeducacionais para redução da ansiedade |
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...
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Aplicar intervenções psicoeducacionais para diminuir ansiedade e ressignificar experiências de delirium |
Comunicação entre equipe e paciente |
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...
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Melhorar a comunicação entre equipe e paciente ao: identificar-se cada vez que encontrar o paciente, oferecer repetidamente lembretes verbais, não utilizar linguajar extremamente técnico, dirigir-se ao paciente pessoalmente com instruções objetivas |
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...
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Evitar confrontos com o paciente, agir de maneira calma e repetir orientações sempre que necessário |
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...
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Considerar se é necessário um intérprete no caso de deficiências sensoriais |
Avaliação e monitoramento do paciente pela equipe |
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...
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Monitorar diariamente o paciente, desde a admissão até a alta, com atenção a aspectos, como: avaliar sinais vitais, status do fluido-eletrólito, saturação de oxigênio, status respiratório e cardiovascular, possíveis infecções na pele, deficit neurológico |
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...
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Aplicar o Delirium Observation Screening, de manhã, tarde e noite, para avaliar e monitorar o 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...
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Realizar avaliação cognitiva |
Estimulação cognitiva |
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...
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Oferecer atividades cognitivamente estimulantes, de maneira precoce, regular e individualizadas |
Organização da rotina |
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...
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Implementar uma rotina de atividades diurnas, organizada em horários, incluindo tarefas funcionais e períodos de descanso |
Musicoterapia |
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...
, 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...
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Utilizar musicoterapia |
Cromoterapia |
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...
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Utilizar terapia com luz |
Terapias relaxantes |
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...
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Aplicar técnicas de relaxamento e massoterapia para auxiliar na melhora da agitação e do sono |
Medicina alternativa e complementar |
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...
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Utilizar práticas, como: técnicas da medicina chinesa, ayurveda, homeopatia/medicina naturopática, terapia assistida por animais, arteterapia, imagens guiadas, meditação, musicoterapia, oração, acupressão, quiropraxia/terapia manipulativa e massagem, uso de suplementos alimentares e produtos à base de plantas, Qigong, reiki, toque terapêutico e terapias baseadas em bioeletromagnética |
Pacote ABCDEF |
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...
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Implementar as estratégias que compõem o pacote ABCDEF, que se referem, respectivamente, ao “teste de acordar/despertar espontaneamente”, “ensaios diários de respiração espontânea”, à escolha adequada de sedativos, à retirada do paciente da ventilação mecânica e da UTI o mais breve possível, à realização de mobilização precoce para reduzir o delirium e melhorar os resultados cognitivos a longo prazo e realizar intervenções que visem envolver e empoderar a família |
Programa de Vida para Idosos no 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...
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Reorientar o paciente com calendários de parede, quadros com fotografias da família, visitas de amigos e familiares; promover a mobilização precoce; favorecer um ambiente noturno tranquilo com a ingestão de bebidas quentes e música agradável; reduzir a luz e ruído ambiental; evitar controles desnecessários; e manter a hidratação e nutrição adequadas |