A Clinical Update on Delirium: Focus on the Intensive Care Unit Patient

Acute care nurse practitioners manage a wide range of patient diagnoses and problems encountered in critical care, including management of delirium. As such, they are positioned to be leaders in the prevention, recognition, and management of delirium in the intensive care unit setting. Delirium in the hospitalized patient is linked with a prolonged length of stay, higher risk of death, and cognitive decline. Delirium will occur in up to 87% of intensive care unit patients with severe illness or recovering from major surgery. This overview of current evidence-based practice guidelines and an accompanying case study will assist interdisciplinary teams of health care providers to diagnose, treat, and manage hospitalized patients with delirium, with a focus on the complex care of the critically ill patient population. •New evidence questions the use of routine antipsychotics to manage delirium.•Guidelines including nonpharmacologic therapy should be considered in managing intensive care unit delirium.•Using screening tools increases the likelihood of early diagnosis and management of delirium.•Multidisciplinary strategies are needed to decrease risk factors for delirium.