Q What tools are available and validated to assess delirium in intensive care unit (ICU) patients? Can the same tools be used with intubated and sedated patients?

A Carrie Sona, RN, MSN, CCRN, CCNS, replies:

Delirium is a sudden, fluctuating, and usually reversible disturbance of mental function. It is characterized by inability to pay attention, disorientation, an inability to think clearly, and fluctuations in the level of alertness (consciousness).1 

The Society of Critical Care Medicine clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult recommend routine monitoring of delirium in ICU patients.2 Delirium is highly prevalent in hospitalized patients and is reported to occur in 20% to 50% of nonintubated ICU patients and in 60% to 80% of patients receiving mechanical ventilation.3 –10 

Delirium is described as either hyperactive or hypoactive on the basis of the patients’ psychomotor behavior....

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