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Pediatric Delirium: Early Identification of Barriers to Optimize Success of Screening and Prevention

Aimee Franken, Danielle Sebbens, Jennifer Mensik

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |November 20, 2018
    PubMed

    Insights

    Implementing nonpharmacologic nursing bundles in pediatric intensive care units did not significantly reduce delirium incidence. Further research is needed to prove consistent reduction and address implementation barriers in complex pediatric settings.

    Area of Science:

    • Pediatric critical care medicine
    • Nursing interventions
    • Delirium management

    Background:

    • Pediatric delirium affects 25% of patients in pediatric intensive care units (PICUs).
    • Nonpharmacologic nursing bundles are a potential strategy for delirium prevention.
    • The consistent effectiveness of these bundles in reducing pediatric delirium is not yet established.

    Purpose of the Study:

    • To evaluate the impact of implementing nonpharmacologic nursing bundles on pediatric delirium incidence.
    • To assess the effectiveness of these interventions in a pediatric intensive care unit setting.

    Main Methods:

    • A nonpharmacologic nursing bundle was implemented for pediatric intensive care unit patients aged 2-18 years.
    • The Cornell Assessment of Pediatric Delirium (CAP-D) screening tool was used for data collection.

    Main Results:

    • No statistically significant difference was observed in CAP-D scores between the control and post-bundle groups (p=0.08).
    • Delirium intervention rates were 26.7% in the control group versus 31.6% in the post-bundle group.
    • Implementation of the bundles faced significant barriers in the complex PICU environment.

    Conclusions:

    • Nonpharmacologic bundles show promise for delirium reduction but require further proof of consistent efficacy.
    • Significant barriers hinder the consistent implementation of these bundles in pediatric intensive care settings.
    • More research is needed to optimize the use of nonpharmacologic interventions for pediatric delirium prevention.
    Abstract

    Keywords:
    Deliriumdelirium preventionnonpharmacologic bundlespediatric delirium

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