Delirium Chapter Summary

roduction

This chapter will provide an overview of delirium and will discuss the necessity and rationale for studying the trajectory of delirium in the intensive care unit (ICU) setting. Previous research conducted on the topic of delirium as well as the impact of delirium on patients, practitioners, and society will be reviewed. The gaps in the literature, the need for additional research and the focus of this research study will be discussed. The research design, terminology and the assumptions, limitations, and delimitations of this research study will be reviewed.

Delirium is a major concern in the intensive care unit (ICU) as it has been directly related to increases in hospital stays and mortality (Bakker, Osse, Tulen, Kappetein, & Bogers,

Understanding the trajectory of delirium is important as anticipated therapies will reduce the potential for significant injury and complications associated with the care of ICU patients. Fan et al. had their (2012) main focus on management approaches, maintaining safe environments and nursing care interventions for delirium and not the predictive manifestations of this common condition. The aim of this quantitative retrospective correlational study is to determine the trajectory of delirium in the mechanically ventilated patient in the adult CVICU, with the intention of implementing early interventions leading to the prevention of delirium. In addition, all conclusions indicate that further studies should be conducted and directed toward the early detection of delirium in ICU patients to obtain a better understanding of this cognitive dysfunction (Bakker et al., 2012; Bigatello et al., 2013; Cavallazzi, Saad, & Marik, 2012; Choi, 2013; Engstrom, Nystrom, Sundelin, & Rattray, 2013; Fan et al., 2012; Hoolahan, 2011; Inouye et al., 1990; Jannati, Bagheri-Nesami, Sohrabi, Yazdani-Cherati, & Mazdarani, 2014; Katz & McNeely, 2013). Delirium continues to represent the most understudied non-pulmonary disorder

In the ICU environment, changes in cognition and disturbances in consciousness most frequently occur during the day over a short period (Morandi, Brummel & Ely, 2011). Therefore, the time limit for this study is postoperative days 1-5. This study will investigate the trajectory of delirium by evaluating the relationship between the independent variable of “mechanical ventilation time” and the dependent variable of “onset of delirium” with a covariant of initial cognitive functioning in patients cared for in the adult Cardiovascular Intensive Care Unit