Improving the Recognition and Assessment of ICU Delirium

Background: Delirium is acute neurological failure that alters cognition and results in a state of confusion and lack of self-awareness. It commonly affects critically ill patients within intensive care units (ICUs), and the wide array of fluctuating symptoms frequently leads to underdiagnosis. Delirium results in cognitive impairment and increased rates of fatality, and accurate assessments are essential for improving patient outcomes. Barriers to delirium assessment stem from a lack of knowledge and assessment training among ICU nurses. Method: Using the Cumulative Index to Nursing and Allied Health Literature electronic database, a literature synthesis was conducted, analyzing journal articles addressing delirium education and training among ICU nurses and barriers associated with assessment. Results: Current literature identifies methods to overcome barriers through training, education, and continuous reinforcement of delirium assessment. The goals of this review are to identify the barriers to delirium assessment and make recommendations for education methods to increase the confidence of ICU nurses in the recognition of delirium to improve patient outcomes. Conclusion: Early identification of delirium is crucial to improving patient outcomes. A standardized delirium educational program should be developed and implemented throughout the U.S. health care system. [ J Contin Educ Nurs. 202x;5x(x):xx–xx.]