Paper for Nursing: Intensive Care Unit (ICU) Delirium.
The significant clinical issue I have chosen to further research is Intensive Care Unit (ICU) delirium. Working in an ICU, I have witnessed ICU delirium first hand. It is quite common in the Trauma ICU in my hospital, because it has no windows. ICU delirium is a significant issue, because it has been linked to negative patient outcomes such as longer hospital stays and higher risk of mortality. It is a serious issue, because it can be hard to assess until it has already become full blown. There are suggested tools and preventive measures, but no solid treatment. Paper for Nursing: Intensive Care Unit (ICU) Delirium.
Every patient in the ICU is at risk for developing ICU delirium. On my floor I would say at least 25% of the patients have ICU delirium. Standard practice at my hospital is to use the CAM-ICU scale once per shift to assess for delirium. It is common to look through a patient’s chart and see “unable to assess” in the comments. This is related to the patient being intubated, sedated, and/or the nurse not knowing the patient’s baseline. Another gap in knowledge is in relation to the fact that there are subtypes of ICU delirium.
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According to Jun Gwon (2013) “Physicians and other caregivers in the ICU usually notice agitation as a consequence whereas patient with hypoactive delirium, which is a more frequent subtype . . . remain unnoticed” (p. 195). Noticing that a patient has become aggressive and irritated comes easily, but noticing a patient is not as talkative or less engaged can easily get missed. Paper for Nursing: Intensive Care Unit (ICU) Delirium.
Chamberlain School of Nursing (2015). Reading research literature – The research process – Lesson. [Online lecture, Week 2]. Retrieved from nursingonline.chamberlain.edu
Houser, J. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones & Bartlett.
Jun Gwon, C. (2013). Delirium in the intensive care unit. Korean Journal of Anesthesiology, 65(3), 195-202. doi: 10.4097/kjae/2013.65.3.195 Paper for Nursing: Intensive Care Unit (ICU) Delirium.