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Updated: May 10, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Patient Agitation in the Intensive Care Unit: A Concept Analysis.

Anne Mette N Adams1,2, Diane Chamberlain1,2, Charlotte Brun Thorup3

  • 1College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.

Journal of Advanced Nursing
|April 25, 2025
PubMed
Summary

Patient agitation in intensive care units (ICUs) is complex, impacting patients and staff. Understanding its causes and consequences is crucial for developing effective, multifaceted management strategies beyond medication.

Keywords:
agitationconcept analysiscritical caredeliriumintensive care unitnursingpatient and family Centred carequality and safety

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Area of Science:

  • Critical Care Medicine
  • Nursing Science
  • Psychology

Background:

  • Patient agitation in intensive care units (ICUs) is a significant concern with negative outcomes for patients, families, and staff.
  • Lack of a clear consensus definition hinders effective prevention and management strategies for ICU agitation.

Purpose of the Study:

  • To explore and define the concept of patient agitation within the intensive care unit setting.
  • To identify the attributes, antecedents, and consequences of patient agitation in the ICU.

Main Methods:

  • A concept analysis using Walker and Avant's eight-step approach.
  • A comprehensive literature search across MEDLINE, PsychINFO, and CINAHL databases.
  • Analysis of 32 papers published between 1992 and 2023 on patient agitation.

Main Results:

  • Patient agitation in the ICU is characterized by excessive motor activity, emotional tension, cognitive impairment, and disruptive behaviors.
  • Antecedents include critical illness, medications, discomfort, patient characteristics, and staff behaviors.
  • Consequences range from interrupted treatments and poor outcomes to psychological distress for all involved.

Conclusions:

  • ICU agitation is a complex issue impacting patient treatment and clinical outcomes, affecting healthcare professionals' workload and job satisfaction.
  • Multifaceted management strategies are essential, not solely relying on pharmacological interventions.
  • Further research is needed to develop improved prevention and management strategies for patient agitation in the ICU.