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Delirium in Children: Identification, Prevention, and Management
Amanda Bettencourt1,2, Jodi E Mullen3,4
1Amanda Bettencourt is a pediatric clinical nurse specialist at UF Health Shands Children's Hospital, Gainesville, Florida.
Insights
Pediatric delirium, a serious hospitalization complication, presents as agitation or lethargy. Early recognition and nursing interventions are crucial for preventing harm and improving outcomes in hospitalized children.
Area of Science:
- Pediatrics
- Critical Care Nursing
Background:
- Delirium in hospitalized children is frequently underrecognized.
- It manifests as agitation, lethargy, or altered mental status, posing risks like self-harm and tube dislodgement.
- Pediatric delirium is linked to increased mortality, morbidity, and posttraumatic stress disorder.
Purpose of the Study:
- To highlight the significance of delirium in pediatric hospitalizations.
- To emphasize the critical role of pediatric nurses in recognizing and managing delirium.
- To advocate for evidence-based nursing interventions for delirium prevention and treatment.
Main Methods:
- This is a review and synthesis of existing knowledge on pediatric delirium.
- Focuses on clinical presentation, risks, and nursing management strategies.
- Highlights the importance of non-pharmacological interventions.
Main Results:
- Delirium is a serious complication associated with poor outcomes in children.
- Pediatric nurses are pivotal in identifying and managing delirium.
- Non-pharmacological interventions are key components of excellent nursing care for delirium.
Conclusions:
- Pediatric nurses are essential in preventing and treating delirium.
- Effective nursing care, including non-pharmacological strategies, can mitigate the risks and consequences of pediatric delirium.
- Recognizing delirium is vital for improving hospitalized children's clinical status and overall well-being.
Abstract:
Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder. Pediatric nurses are uniquely positioned to design care interventions to both reduce risk for delirium and treat active delirium. Many treatment recommendations are nonpharmacological and are part of excellent nursing care.
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