A pilot volunteer reader programme decreases delirium days in critically ill, adult ICU patients

[摘要] Delirium, a form of acute brain dysfunctionpresenting as altered mental status, andimpairment of memory, emotion, thinking,perception and behaviour1 develops overhours to days2 and is seen in 20%–80%1 3of adult intensive care unit (ICU) patients,depending on the diagnostic method andseverity of illness. Delirium diagnosis is oftenmissed, as only 25% of patients experiencingthis disorder are hyperactive.1 3 More prevalent is hypoactive delirium: patients appearingsedated, responding slowly to instructionsor questions and, rarer still, mixed deliriumpatients may be hyperactive and hypoactive.3 4 There is also subsyndromal delirium,representing an intermediate state—notnormal and yet not fully developed delirium.Delirium can lead to serious complicationsincluding increased length of ICU stay andincreased readmission, institutionalisationand mortality rates.3 5 If not diagnosed ortreated, delirium may lead to irreparable6and delayed7–9 cognitive failure.

[学科分类] 药学

[关键词] continuous quality improvement;critical care;patient-centred care;patient satisfaction;quality improvement