Joan Lynch1, Kaye Rolls2, Yu Chin Hou3, Sonja Hedges4, Masar Al Sayfe5, Sharon-Ann Shunker6, Kathleen Brennan4, David Sanchez7, Tony Bogdanovski6, Leanne Hunt1, Evan Alexandrou1, Steven A Frost8. 1. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; School of Nursing and Midwifery, Western Sydney University, Australia; Intensive Care Unit Liverpool Hospital, Australia. 2. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; School of Nursing and Midwifery, Western Sydney University, Australia; Intensive Care Fairfield Hospital, Australia; School of Nursing, University of Wollongong, Australia. Electronic address: Kaye.rolls@westernsydney.edu.au. 3. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; Intensive Care Unit Liverpool Hospital, Australia; Centre for Applied Nursing Research, SWSLHD, Australia. 4. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; Intensive Care Bankstown Hospital, Australia; Centre for Applied Nursing Research, SWSLHD, Australia. 5. Intensive Care Fairfield Hospital, Australia. 6. Intensive Care Unit Liverpool Hospital, Australia. 7. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; Intensive Care Unit Campbelltown Hospital, South Western Sydney Local Health District, Australia. 8. Critical Care Research in Collaboration and Evidence Translation (CCRICET), Australia; School of Nursing and Midwifery, Western Sydney University, Australia; Intensive Care Unit Liverpool Hospital, Australia; Centre for Applied Nursing Research, SWSLHD, Australia.
Abstract
BACKGROUND: Delirium is an acute disorder of attention and cognition with the highest rates among adults receiving intensive care. An acute episode of delirium is associated with morbidity and mortality, as well as a significant psychological sequela. Importantly, an increasing body of evidence supports the benefit of nonpharmacological, nurse-led interventions to reduce the incidence and duration of delirium among adults cared for in the intensive care unit (ICU). OBJECTIVES: This study will evaluate the impact of a nursing-led delirium prevention protocol that is aimed at reducing the incidence and duration of delirium among adults admitted to the ICU. The delirium prevention nursing protocol specifically targets risk factors for delirium. STUDY PLAN: A stepped-wedge cluster randomised controlled trial approach will be used to assess the effectiveness of the nurse-led intervention, in four adult ICUs across the South Western Sydney Local Health District (SWS-LHD), over a 12-month period. The primary outcomes of interest are (i) the incidence of delirium before and after the implementation of the nurse-led intervention and (ii) the number of delirium-free days during an ICU stay, before and after the implementation of the nurse-led intervention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): (ACTRN12618000411246p).
RCT Entities:
BACKGROUND:Delirium is an acute disorder of attention and cognition with the highest rates among adults receiving intensive care. An acute episode of delirium is associated with morbidity and mortality, as well as a significant psychological sequela. Importantly, an increasing body of evidence supports the benefit of nonpharmacological, nurse-led interventions to reduce the incidence and duration of delirium among adults cared for in the intensive care unit (ICU). OBJECTIVES: This study will evaluate the impact of a nursing-led delirium prevention protocol that is aimed at reducing the incidence and duration of delirium among adults admitted to the ICU. The delirium prevention nursing protocol specifically targets risk factors for delirium. STUDY PLAN: A stepped-wedge cluster randomised controlled trial approach will be used to assess the effectiveness of the nurse-led intervention, in four adult ICUs across the South Western Sydney Local Health District (SWS-LHD), over a 12-month period. The primary outcomes of interest are (i) the incidence of delirium before and after the implementation of the nurse-led intervention and (ii) the number of delirium-free days during an ICU stay, before and after the implementation of the nurse-led intervention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): (ACTRN12618000411246p).
Authors: David Sanchez; Kathleen Brennan; Masar Al Sayfe; Sharon-Ann Shunker; Tony Bogdanoski; Sonja Hedges; Yu Chin Hou; Joan Lynch; Leanne Hunt; Evan Alexandrou; Manoj Saxena; Simon Abel; Ramanathan Lakshmanan; Deepak Bhonagiri; Michael J Parr; Anders Aneman; Danielle Ni Chroinin; Kenneth M Hillman; Steven A Frost Journal: Crit Care Date: 2020-10-15 Impact factor: 9.097