Archives of Neuroscience

Published by: Kowsar

Efficacy of Liaison Education and Environmental Changes on Delirium Incidence in ICU

Mohammad Arbabi 1 , 2 , Jayran Zebardast 3 , Ahmad Ali Noorbala 2 , Mostafa Mohamadi 4 , Mohsen Rahimnia 1 , * and Roja Larijani 5
Authors Information
1 Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Psychosomatic Ward, Imam Khomeini Hospital Tehran, Tehran University of Medical Sciences, Iran
3 Virtual School, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Intensive Care Unit, Imam Khomeini Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Psychology, Tarbiat Moalem University, Tehran, Iran
Article information
  • Archives of Neuroscience: April 2018, 5 (2); e56019
  • Published Online: April 20, 2018
  • Article Type: Research Article
  • Received: June 23, 2017
  • Accepted: January 6, 2018
  • DOI: 10.5812/archneurosci.56019

To Cite: Arbabi M, Zebardast J, Noorbala A A, Mohamadi M, Rahimnia M, et al. Efficacy of Liaison Education and Environmental Changes on Delirium Incidence in ICU, Arch Neurosci. 2018 ; 5(2):e56019. doi: 10.5812/archneurosci.56019.

Copyright © 2018, Archives of Neuroscience. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29(7):1370-9. doi: 10.1097/00003246-200107000-00012. [PubMed: 11445689].
  • 2. Inouye SK. Delirium in older persons. N Engl J Med. 2006;354(11):1157-65. doi: 10.1056/NEJMra052321. [PubMed: 16540616].
  • 3. Inouye SK, Bogardus SJ, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340(9):669-76. doi: 10.1056/NEJM199903043400901. [PubMed: 10053175].
  • 4. Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286(21):2703-10. doi: 10.1001/jama.286.21.2703. [PubMed: 11730446].
  • 5. Pisani MA, Kong SY, Kasl SV, Murphy TE, Araujo KL, Van Ness PH. Days of delirium are associated with 1-year mortality in an older intensive care unit population. Am J Respir Crit Care Med. 2009;180(11):1092-7. doi: 10.1164/rccm.200904-0537OC. [PubMed: 19745202].
  • 6. Morandi A, Brummel NE, Ely EW. Sedation, delirium and mechanical ventilation: the 'ABCDE' approach. Curr Opin Crit Care. 2011;17(1):43-9. doi: 10.1097/MCC.0b013e3283427243. [PubMed: 21169829].
  • 7. Mitasova A, Kostalova M, Bednarik J, Michalcakova R, Kasparek T, Balabanova P, et al. Poststroke delirium incidence and outcomes: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2012;40(2):484-90. doi: 10.1097/CCM.0b013e318232da12. [PubMed: 22001583].
  • 8. Roberts B. Screening for delirium in an adult intensive care unit. Intensive Crit Care Nurs. 2004;20(4):206-13. doi: 10.1016/j.iccn.2004.04.003. [PubMed: 15288874].
  • 9. Wang W, Li HL, Wang DX, Zhu X, Li SL, Yao GQ, et al. Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: a randomized controlled trial*. Crit Care Med. 2012;40(3):731-9. doi: 10.1097/CCM.0b013e3182376e4f. [PubMed: 22067628].
  • 10. Aldemir M, Ozen S, Kara IH, Sir A, Bac B. Predisposing factors for delirium in the surgical intensive care unit. Crit Care. 2001;5(5):265-70. doi: 10.1186/cc1044. [PubMed: 11737901].
  • 11. Pun BT, Gordon SM, Peterson JF, Shintani AK, Jackson JC, Foss J, et al. Large-scale implementation of sedation and delirium monitoring in the intensive care unit: a report from two medical centers. Crit Care Med. 2005;33(6):1199-205. doi: 10.1097/01.CCM.0000166867.78320.AC. [PubMed: 15942331].
  • 12. Devlin JW, Fong JJ, Howard EP, Skrobik Y, McCoy N, Yasuda C, et al. Assessment of delirium in the intensive care unit: nursing practices and perceptions. Am J Crit Care. 2008;17(6):555-65. quiz 566. [PubMed: 18978240].
  • 13. Koster S, Hensens AG, Schuurmans MJ, van der Palen J. Risk factors of delirium after cardiac surgery: a systematic review. Eur J Cardiovasc Nurs. 2011;10(4):197-204. doi: 10.1016/j.ejcnurse.2010.09.001. [PubMed: 20870463].
  • 14. Pipanmekaporn T, Wongpakaran N, Mueankwan S, Dendumrongkul P, Chittawatanarat K, Khongpheng N, et al. Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Clin Interv Aging. 2014;9:879-85. doi: 10.2147/CIA.S62660. [PubMed: 24904208].
  • 15. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289(22):2983-91. doi: 10.1001/jama.289.22.2983. [PubMed: 12799407].
  • 16. Van Rompaey B, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Elseviers M, Bossaert L. A comparison of the CAM-ICU and the NEECHAM Confusion Scale in intensive care delirium assessment: an observational study in non-intubated patients. Crit Care. 2008;12(1):R16. doi: 10.1186/cc6790. [PubMed: 18282269].
  • 17. Girard TD, Pandharipande PP, Ely EW. Delirium in the intensive care unit. Crit Care. 2008;12 Suppl 3. S3. doi: 10.1186/cc6149. [PubMed: 18495054].
  • 18. Marshall MC, Soucy MD. Delirium in the intensive care unit. Crit Care Nurs Q. 2003;26(3):172-8. doi: 10.1097/00002727-200307000-00002. [PubMed: 12930032].
  • 19. Wong N, Abraham G. Managing Delirium In The Emergency Department: Tools For Targeting Underlying Etiology. Emerg Med Pract. 2015;17(10):1-20. quiz 21. [PubMed: 26367083].
  • 20. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care. 2009;13(3):R77. doi: 10.1186/cc7892. [PubMed: 19457226].
  • 21. Tabet N, Howard R. Non-pharmacological interventions in the prevention of delirium. Age Ageing. 2009;38(4):374-9. doi: 10.1093/ageing/afp039. [PubMed: 19460856].
  • 22. Devlin JW, Fong JJ, Schumaker G, O'Connor H, Ruthazer R, Garpestad E. Use of a validated delirium assessment tool improves the ability of physicians to identify delirium in medical intensive care unit patients. Crit Care Med. 2007;35(12):2721-4. quiz 2725. doi: 10.1097/01.CCM.0000292011.93074.82. [PubMed: 18074477].
  • 23. Gesin G, Russell BB, Lin AP, Norton HJ, Evans SL, Devlin JW. Impact of a delirium screening tool and multifaceted education on nurses' knowledge of delirium and ability to evaluate it correctly. Am J Crit Care. 2012;21(1):e1-11. doi: 10.4037/ajcc2012605. [PubMed: 22210704].
  • 24. Devlin JW, Marquis F, Riker RR, Robbins T, Garpestad E, Fong JJ, et al. Combined didactic and scenario-based education improves the ability of intensive care unit staff to recognize delirium at the bedside. Crit Care. 2008;12(1):R19. doi: 10.1186/cc6793. [PubMed: 18291021].
  • 25. Freedman NS, Gazendam J, Levan L, Pack AI, Schwab RJ. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med. 2001;163(2):451-7. doi: 10.1164/ajrccm.163.2.9912128. [PubMed: 11179121].
  • 26. Abraha I, Trotta F, Rimland JM, Cruz-Jentoft A, Lozano-Montoya I, Soiza RL, et al. Efficacy of Non-Pharmacological Interventions to Prevent and Treat Delirium in Older Patients: A Systematic Overview. The SENATOR project ONTOP Series. PLoS One. 2015;10(6). e0123090. doi: 10.1371/journal.pone.0123090. [PubMed: 26062023].
  • 27. Siddiqi N, Stockdale R, Britton AM, Holmes J. Interventions for preventing delirium in hospitalised patients. Cochrane Database Syst Rev. 2007;(2). CD005563. doi: 10.1002/14651858.CD005563.pub2. [PubMed: 17443600].
  • 28. Brummel NE, Girard TD. Preventing delirium in the intensive care unit. Crit Care Clin. 2013;29(1):51-65. doi: 10.1016/j.ccc.2012.10.007. [PubMed: 23182527].
  • 29. Cole MG, Primeau F, McCusker J. Effectiveness of interventions to prevent delirium in hospitalized patients: a systematic review. CMAJ. 1996;155(9):1263-8. [PubMed: 8911292].
  • 30. Clegg A, Siddiqi N, Heaven A, Young J, Holt R. Interventions for preventing delirium in older people in institutional long-term care. Cochrane Database Syst Rev. 2014;(1). CD009537. doi: 10.1002/14651858.CD009537.pub2. [PubMed: 24488526].
  • 31. Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2009;5(4):210-20. doi: 10.1038/nrneurol.2009.24. [PubMed: 19347026].
  • 32. Kosten TR, O'Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. 2003;348(18):1786-95. doi: 10.1056/NEJMra020617. [PubMed: 12724485].
  • 33. Schuckit MA. Drug and alcohol abuse: A clinical guide to diagnosis and treatment. Springer Science & Business Media; 2006.
  • 34. Ely EW, Gautam S, Margolin R, Francis J, May L, Speroff T, et al. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med. 2001;27(12):1892-900. doi: 10.1007/s00134-001-1132-2. [PubMed: 11797025].
  • 35. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med. 2007;33(1):66-73. doi: 10.1007/s00134-006-0399-8. [PubMed: 17102966].
  • 36. Thomason JW, Shintani A, Peterson JF, Pun BT, Jackson JC, Ely EW. Intensive care unit delirium is an independent predictor of longer hospital stay: a prospective analysis of 261 non-ventilated patients. Crit Care. 2005;9(4):R375-81. doi: 10.1186/cc3729. [PubMed: 16137350].
  • 37. Milbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, et al. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004;32(4):955-62. doi: 10.1097/01.CCM.0000119429.16055.92. [PubMed: 15071384].
  • 38. Robinson BR, Mueller EW, Henson K, Branson RD, Barsoum S, Tsuei BJ. An analgesia-delirium-sedation protocol for critically ill trauma patients reduces ventilator days and hospital length of stay. J Trauma. 2008;65(3):517-26. doi: 10.1097/TA.0b013e318181b8f6. [PubMed: 18784563].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments