Mitra Zolfaghari, Mohamad Arbabi, Shadan Pedram Razi, Khadijeh Biat, Ali Bavi,
Volume 18, Issue 1 (3-2012)
Abstract
Background & Aim: Delirium is a common problem among patients with open heart surgery admitted to intensive care units. This study aimed to assess effectiveness of a multifactor intervention on delirium prevention and length of stay in patients with open heart surgery.
Methods & Materials: In this semi-experimental study, we first recruited 195 patients. Among them, 15 patients were excluded during the study due to different reasons. The participants were divided into to study groups. The implemented intervention included staff education, environment changes, and installation of guideline reminding on ward. Patients were assessed for delirium twice a day using the CAM-ICU scale. Demographic characteristics as well as disease and sleep items were completed by the researchers a day before surgery. Moreover, length of stay was recorded by the researchers. Data were analyzed using Pearson Chi-Square, Independent Samples, and the Fisher&aposs Exact Test.
Results: A significant decrease was found in the incidence of delirium in the intervention group: 11.1% Vs 35.6% (P<0.05). Average length of stay in the control and intervention groups was 6.23 Vs 6.30 days, respectively. Length of stay among patients with delirium and patients without delirium was 7.5 Vs 5.8 days, respectively. Patients with delirium were aged 55 and more in both groups.
Conclusion: Multifactor intervention was effective in decreasing the prevalence of delirium. Educational interventions are recommended to improve staffs&apos knowledge and environment changes.
Ali Hasanshahian, Ali Ravari, Tayebeh Mirzaei,
Volume 24, Issue 4 (1-2019)
Abstract
Background & Aim: Active participation of families can be an influencing factor on delirium in patients hospitalized in the ICU. The present study was conducted to investigate the effect of scheduled visits on delirium intensity in elderly patients hospitalized in the ICU.
Methods & Materials: This clinical trial was conducted on 70 elderly patients hospitalized in the ICU of Ali ibn Abi Talib hospital in Rafsanjan from November 1, 2017 to March 1, 2018. In the intervention group, patients were visited in two out-of-schedule sessions for three days in the morning and night. The control group received routine visits for 3-5 minutes. To assess delirium, the Neecham questionnaire with a scoring scale of 19-30 was used. The data were analyzed using the SPSS software version18.
Results: There was no statistically significant difference between the two groups in terms of age, sex and educational level. Before the intervention and one day after the intervention, no significant difference was observed in delirium score between the two groups. However, on the second day in the intervention group, the median and interquartile range for delirium were 27(3) and in the control group were 25(2) (P<0.0001). On the third day after the intervention, differences between delirium score in the intervention and control groups were 27(3) and 25(3), respectively (P<0.0001).
Conclusion: Scheduled visits can be considered an effective non-pharmacological method for preventing delirium in elderly patients hospitalized in the ICU.
Clinical trial registry: IRCT20150519022320N7
Javad Malekzadeh, Mahsa Quchani, Ahmad Bagheri Moghadam, Tahereh Sadeghi, Mohammad Rajabpour,
Volume 30, Issue 2 (6-2024)
Abstract
Background & Aim: With advancements in treatment and an increase in the prevalence of diseases, the number of patients requiring mechanical ventilation in intensive care units (ICUs) continues to rise each year. The ABCDE bundle is a multi-component, evidence-based approach designed to improve patient outcomes in the ICU. This study aimed to determine the effect of the ABCDE bundle on the risk of pressure ulcers, deep vein thrombosis and delirium in patients undergoing mechanical ventilation.
Methods & Materials: This randomized, single-blind clinical trial was conducted between September 2021 and January 2022. The sample included 100 patients undergoing mechanical ventilation in the ICU department of Imam Reza Hospital in Mashhad, who were randomly assigned to either the intervention or control group using block randomization. The intervention group received the ABCDE bundle over a period of 7 days. The control group received routine care. The criteria for assessing complications included the risk of pressure ulcers and deep vein thrombosis (DVT), evaluated at the end of the intervention and on days 0, 1, 3, 5, and 7. The study utilized several assessment tools: the COMHON Index for pressure ulcers, the Wells Deep Vein Thrombosis Scale, and the Delirium Evaluation Tool in the Intensive Care Unit (CAM-ICU). Data analysis was performed using SPSS software version 20, employing chi-square, Mann-Whitney, and independent t-tests.
Results: A decrease in the average pressure ulcer risk score was observed in the intervention group on day seven (P<0.05). In this group, the incidence of delirium fell decreased from 64.4% to 13.3% (P<0.05), indicating a statistically significant reduction. Additionally, the risk score for deep vein thrombosis in the control group significantly increased on day seven compared to the intervention group (P<0.05).
Conclusion: The use of the ABCDE bundle significantly reduces the risk of pressure ulcers, deep vein thrombosis, and delirium in patients undergoing mechanical ventilation and represents an effective strategy that can be implemented by nurses and other trained healthcare professionals.
Clinical trial registry: IRCT20190625044000N1
