Delirium Assessment and Management

Delirium is an acute change in consciousness that is accompanied by inattention and either a change in cognition or perceptual disturbance.¹  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.¹  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 teams have considered delirium to be a...