HOSPITAL ASSOCIATED DELIRIUM: PREVENTION AND MANAGEMENT BY REGISTERED NURSES

Abstract

Purpose: To explore various hospital associated triggers of delirium in the acute care setting and develop best practice recommendations focusing on nonpharmacological interventions and environmental alterations informed by the evidence found. Background: Delirium is one of the most common organ dysfunctions in acute care patients yet is profoundly under-diagnosed and misdiagnosed, leading to poor outcomes including mortality. An effective way to reduce the incidence of delirium is to implement environmental prevention and management strategies to identify and treat acute, precipitating, modifiable risk factors. Approach to practice: The best practice recommendations are based on a literature review conducted through a search on CINAHL using the following search terms: "delirium," "hospital or acute setting," "causes or factors," "precipitating factors," and "prevention or treatment or management." There are ten articles included in this review that were published between 2013 and 2021. Outcomes: Fifteen evidence-informed best practice recommendations were developed. These recommendations aim to educate registered nurses (RNs) in acute care settings on delirium prevention and management by environmental alteration in order to decrease delirium incidence. A theoretical dissemination plan for the implementation of these recommendations was proposed. Conclusions: Recommendations made in this thesis can be used as a starting point for delirium prevention and management in acute care settings by RNs, but a wider base of high-level evidence, interventional research is required to further validate the significance of evidence-based recommendations involving environmental alteration to prevent and manage delirium.