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Nursing workload during delirium: a systematic literature review
Jens Wuschke1,2,3, Patrick Kutschar4, Peter Nydahl4,5
1Department of Neurology and Department of Nursing and Therapeutic Services, University Teaching and Research Hospital, HOCH Health Eastern Switzerland, Cantonal Hospital St.Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland. jens.wuschke@h-och.ch.
Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|November 28, 2025
Summary
Patients with delirium require significantly more nursing care and interventions than those without. This increased workload, particularly due to fall risks, necessitates better nursing staff planning.
Area of Science:
- Nursing Care
- Patient Outcomes
- Healthcare Management
Background:
- Delirium significantly increases the demand for nursing care.
- The precise extent of this additional nursing workload remains insufficiently quantified.
- Delirium prevention and treatment protocols contribute to a substantial nursing workload.
Purpose of the Study:
- To quantify the nursing workload for patients with delirium compared to those without.
- To determine the extent of differences in nursing care requirements.
Main Methods:
- Systematic literature search across PubMed, CINAHL, and Cochrane Library.
- Quality assessment of included studies using the Newcastle-Ottawa Scale (NOS).
Main Results:
- Eight hospital studies from the past 15 years were analyzed, with an average quality of 6.1/9 NOS points.
- Patients with delirium consistently showed higher nursing workload scores.
- These patients required more frequent two-nurse interventions and increased time for observation, monitoring, and fall-related care.
Conclusions:
- Patients with delirium necessitate greater nursing care irrespective of the hospital setting.
- Variations in delirium screening and workload tools limit standardized quantitative analysis.
- Increased nursing workload for delirium patients must be proactively addressed in staffing plans, with potential implications for other healthcare professionals.
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