Delirium is an acute change in consciousness that is accompanied by inattention and either a change in cognition or perceptual disturbance. Patients can have hyperactive delirium (agitation, restlessness, attempting to remove catheters, and/or emotional lability), hypoactive delirium (flat effect, withdrawal, apathy, lethargy, and/or decreased responsiveness), or a combination of both. Delirium affects up to 80% of ICU patients, and it is estimated that ICU costs associated with delirium equal between $4 and $16 billion annually in the United States.2–6 

This form of acute brain dysfunction is associated with increased length of ICU and hospital stays, time receiving mechanical ventilation, mortality, and long-term neuropsychological deficits.7–11  Despite this high prevalence and negative outcomes, delirium in the ICU goes undetected and, thus, untreated in scores of patients.12–17  For many years, critical care nursing and medical...

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