Tracy McClinton DNP, AG-ACNP-BC
Investigative Techniques | Medicine and Health Sciences | Nursing
Delirium is a form of brain malfunction marked by abnormalities in cognition, disorientation, memory, and awareness. This scoping review's aim is to examine bodies of research on the effects of length of stay (LOS) in the ICU using Confusion Assessment Method-Intensive Care Unit (CAM-ICU).
Adults age 18 and older admitted to the ICU, of any race or ethnicity, and any gender were all included in the study articles. Nine articles satisfied the search criteria after publications underwent rapid critical appraisal. Results were evaluated for ICU LOS, hospital LOS, mortality, restraint use, medication use, delirium screening tool use, and screening tool efficacy.
One article demonstrated a decrease in ICU LOS with CAM-ICU delirium detection. Four articles demonstrated detection of delirium by using the CAM-ICU tool. Hospital LOS without CAM-ICU showed increased LOS in three articles and decreased LOS in one article. No effect was reported or examined for ICU LOS without delirium detected by CAM-ICU. Mortality increased for patients with delirium detected by CAM-ICU and non-CAM-ICU tool in two articles and decreased in one article. Mortality without delirium decreased in one article. Other outcomes such as high-risk medication and restraint usage were found in four other articles. These articles demonstrated our desired outcomes and highlight the need for future research on the impact of LOS with early detection of delirium with the CAM-ICU screening tool.
Implications for Nursing Practice
As nurse practitioners, it is our responsibility to be aware of the effects of ICU delirium and to promote the use of CAM-ICU as evidence-based practice to detect delirium to lessen its effects, which in turn reduces mortality and hospital LOS.
Keywords: ICU and hospital length of stay (LOS) for CAM-ICU, ICU and hospital LOS for non-CAM tool delirium mortality with delirium, mortality without delirium, restraint usage, high-risk medication usage, effectiveness of screening tool, and screening tool usage
Felix, Kiara Nicole; Larkin, Anita; Lynn, Kathryn; Reed, Latoya; and McClinton, Tracy DNP, AG-ACNP-BC , "ICU Delirium: Detection with and without CAM-ICU Screening" (2023). Doctor of Nursing Practice Projects. Paper 65. http://dx.doi.org/10.21007/con.dnp.2023.0065.