Evidence -and Betty Neuman's model- based nursing care to prevent deilrium in the intensive care unit

Abstract

Background: Delirium is a fluctuating disturbance in consciousness that is highly prevalent in the intensive care unit. The adult ICU of the Hospital Universitario de Neiva shows an incidence of 28% of delirium patients, this increases morbidity and mortality rates among critical ones; nonetheless, this can be prevented if intervention occurs.

Objective: Determine the effectiveness of To determine the effectiveness of care applied, according to guide nursing care nursing care to prevent delirium in patients, who were hospitalized in the adult intensive care unit, the patients were exposed to environmental stressors.

Methodology: A quantitative, prospective and pre-experimental study was carried out to 49 patients who received assessment with the help of a nursing care guide. Besides the guide, a pretest and a posttest were carried out to evaluate the patients’ perception on environmental stressors.

Results: Three out of the 49 patients experienced delirium; this represents a cumulative incidence of 6.12 delirium cases x 100 patients (CI 95%: 1.67-16.1), evident with the Kaplan-Merier curve. Based on the proportion hypothesis testing (Z ₀.₀₅ = -1.65) and in contrast to previous results where the incidence of delirium was of 28%, the statistical evidence suffices to demonstrate that the presence of the syndrome is much less frequent in patients to whom the nursing care guide.

Conclusions: The guide prevented the occurrence of delirium in 94% of the patients, regardless of their deliriogenic history, by controlling the continuous noise and artificial light. This is why, minimizing environmental stressors, which results in a more pleasant environment, is a fundamental part of nursing care for the prevention of such a syndrome.