2nd International Nursing Conference
November 1-3, 2017 Barcelona, Spain
Importance of Nurses Knowledge of Delirium in the Intensive Care Unit
Saint Maryʼs College, USA
Delirium is an acute central nervous system (CNS) dysfunction, with accompanying change in cognition, characterized by a disturbance of consciousness resulting from any number of common insults that intensive care unit (ICU) patientsʼ experience. It is the brainʼs form of “organ dysfunction.”Delirium typically manifests as a constellation of symptoms with an acute onset and a fluctuating course. Delirium is extremely common in the intensive care unit (ICU) especially amongst mechanically ventilated patients. Intensive care nurses must be trained to identify and manage delirium accurately. In the (ICU) patient, delirium occurs due to factors such as comorbidity, critical illness, and iatrogenesis. These complications of hospital stay are extremely hazardous in older persons and is associated with increased length of stay, institutionalization, and death. Neurologic dysfunction compromises patientsʼ ability to be weaned from mechanical ventilation or achieve full recovery and independence. Yet ICU nurses are usually unaware of the presence of different types of delirium and often times, only recognize this disturbance in agitated patients (hyperactive delirium). There are various delirium assessment tools. Although the CAM-ICU is the most widely studied and validated diagnostic instrument, the accuracy of this tool may be less than ideal without adequate training of the nurses applying it. The presentation will review the definition and salient features of delirium, its primary risk factors, and review validated instrumentsfor delirium assessment that have been developed for ICU nurses, and interventions to be used in delirium management in the ICU.
Keywords: Delirium, Critical illness, Coma, Sedatives, Antipsychotics
Dr. Juliana Mwose is a critical care nurse by background. She currently teaches both graduate and undergraduate nursing students at Saint Mary›s College at Notre Dame, Indiana, USA. Dr. Mwose also holds an advanced practice position with a Pulmonary and Critical Care Associates group where she manages patients with pulmonary diseases. From the day Dr. Mwose entered nursing school, she knew critical care was the areas she was interested in working in. She served as a critical care bedside nurse for 13 years both in acute care and in Long Term Acute Care (LTAC), before joining Pulmonary & Critical Care Associates as an advanced practice nurse. Juliana Mwose attained her undergraduate nursing degree from Indiana University of South Bend, Indiana, USA, Masters degree from Indiana University/Purdue University of Indianapolis with a concentration on Adult health. She proceeded to attain a Doctor of Nursing degree from Valparaiso University in Valparaiso, Indiana, US. In the community, Dr. Mwose has presented on the subject of delirium in the ICU, of which she states that “delirium continue to be a major problem especially in the ICU and there remains an opportunity for healthcare providers to improve the care of the ICU patient with regard to delirium.”