Patients in the intensive care are usually sedated because of mechanical ventilation. Most of these patients experience delirium which occur as a complication associated with longer ICU stay. If the condition is recognized and prevented, there will be high cost reductions and good patient outcomes. The purpose of this presentation is to highlight introduction of assessment of sedation level and delirium in ICU.
Methods
The study used pre-test and intervention design. A baseline data using interviews guide was used to determine nurses' knowledge to assess delirium and level of sedation in ICU. Nurses were informed about the two new tools, Intensive Care Delirium Screening Checklist (ICDSC) and Richmond Agitation Sedation Scale (RASS).
Findings
Thirty-nine patents admitted in the ICU for five months were assessed and the delirium and sedation level scored and treatment plans documented. Patients demographic data: Mediun IQR: age, 40.0(30.-0 - 53.0); ICU LOS in days: 4.8(2.7 -8.0); Length on mechanical ventilator: 3.9 )2.1 -6.8). Twenty-three percent of patients experienced delirium with high prevalence for hypo active delirium sub type. Of the 8 % of patients who stayed more than seven days in ICU, presented with signs of delirium at some point during their stay. Nurses administered sedatives as ordered initially without taking cognizance of patient's sedation level.
Conclusion
Introduction of delirium and sedation level assessment highlighted the incidence of delirium in critically ill patients. Improved recognition of delirium could improve practice. Staff became aware of these tools and how to use them.
Recommendations
More intensified training for nurses on the use of standardized tools for the assessment of delirium and sedation level is necessary. Physicians should be involved during training so that the assessment should be a multidisciplinary effort. Sedation should be based on patients' sedation level and it was evident that there was no tools used for assessing delirium and sedation levels in the unit.
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