A pilot study to test the feasibility of a nonpharmacologic intervention for the prevention of delirium in the medical intensive care unit.

PURPOSE/OBJECTIVES: The aims of this study were to determine the feasibility of and test a multicomponent, nonpharmacologic, nurse-driven intervention for prevention of delirium. DESIGN: This was a prospective, cohort pilot study. SETTING: This study was carried out in a 12-bed medical intensive care unit in a Magnet-designated community hospital in a major metropolitan city in the Southwest United States. SAMPLE: A convenience sample of consented patients meeting inclusion criteria was included in this study. METHODS: A multicomponent prevention protocol consisting of sedation cessation, sleep-wake cycles, sensory stimulation, mobility, and music was tested. FINDINGS: Capturing data for the interventions was problematic. Insufficient documentation systems and inadequate multidisciplinary participation in carrying out the protocol, especially mobility, were barriers. CONCLUSIONS: There was little difference in the proportion of delirium before and after intervention. Success in the identification and prevention of delirium requires a multidisciplinary approach. IMPLICATIONS: Further research is needed using a larger sample size. Refinement of a mobility program is needed.