Hospitals work to reduce 'ICU delirium'

A close-up photo of a vital signs monitor

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For healthcare leaders seeking to improve patient safety, intensive care units (ICUs) have always been fraught, and providers increasingly find themselves facing the threat of “ICU delirium.”

The condition, which occurs suddenly and can induce paranoia and hallucinations, is often a terrifying experience for patients, according to STAT. As many as 8 in 10 ICU patients can be effected, and the experience persists beyond the walls of the hospital; post-traumatic stress disorder affects discharged ICU patients at a rate comparable to combat veterans and survivors of rape.

Wes Ely, M.D., a professor of medicine and critical care at Nashville’s Vanderbilt University Medical Center and cochair of the Society for Critical Care Medicine’s “ICU Liberation Campaign,” is pushing for broader recognition of ICU delirium as a public health issue. To reduce ICU delirium, Ely’s calling on ICU clinicians to cut down on use of ventilators and sedatives and work to get patients back on their feet as soon as possible.

Experts trace the issue in large part to overuse of sedation in the ICU, according to the article. Ely points to an ICU culture that views the practice as necessary to protect patients as a possible cause. Implementing the campaign’s protocols is already yielding promising results; at Beth Israel Deaconess Medical Center, for instance, care teams have cut delirious patients 60 percent since 2012, according to the article.

Hospital leaders must also address the frantic, often understaffed environment in such settings if they wish to cut down on ICU delirium. “You may have one patient going into shock while another needs to be reintubated, so people get busy,” anesthesiologist Matt Aldrich, M.D., an anesthesiologist who’s working on bring the campaign to University of California, San Francisco, Medical Center, where he directs adult critical care, told STAT. “Delirium has definitely taken a backseat.”