Nursing preventive measures against the incidence of delirium in hospitalized patients: a narrative review

Background and Purpose: Delirium is a clinical syndrome with cognitive disorder, which occurs within a short time in the admitted patients, specially the elderly. Regarding the fact that one third of the delirium incidences is preventable, applying nursing preventive measures is an issue of fundamental importance. The present study aimed to perform a systematic review over the nursing preventive measures and their impacts on delirium incidence in the critically ill patients. Methods: This review was conducted on the studies published within early 1999 to late December 2014. The search was performed using the available databases including Google Scholar, Scopus, Science Direct, PubMed, Medline, and Persian databases including Magiran, IranMedex, and SID. The keywords used during the searching process entailed delirium, confusion, non-pharmalogical, multi-component, nursing preventive measures, adult patient, as well as education and nursing measures. A total of 2499 articles were obtained based on the inclusion criteria; however, 19 articles were found to be completely relevant to the topic of interest. Results: The review of the retrieved studies demonstrated that the rate of delirium incidence is different depending on the severity of the disease, applied delirium assessment scales, and causes of hospital stay. A combination of multifactorial interventions including drug administration, preventive care, and modification of risk factors can prevent delirium, reduce the intensity of this medical condition, and decrease the duration of hospital stay. Conclusion: Some measures should be taken in the surgical, elderly, and intensive care units in terms of the prevention and immediate diagnosis of delirium. Since the nursing personnel have the most patient contact, they have a strategic role in preventing and managing this medical condition. Accordingly, it is possible to reduce the delirium incidence and its complications by educating the nurses and spending little expenses.