Nursing workload during delirium: a systematic literature review

Studies indicate that patients with delirium require more nursing care. However, the extent of this additional nursing workload is unclear. Bundles of measures for delirium prevention and treatment measures to prevent and treat delirium cause a substantial and particularly high nursing workload.

What is the nursing workload involved in caring for patients with delirium compared to patients without delirium, and to what extent does it differ?

A systematic literature search was conducted in the PubMed, CINAHL, and Cochrane Library databases. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Eight studies conducted in hospitals over the past 15 years were included. The mean quality of the studies was 6.1 out of a possible 9 NOS points (standard deviation 0.8). The nursing workload for patients with delirium is consistently higher when indices are applied and when workload recording tools are used. Patients with delirium require more frequently nursing interventions with two nurses and more time for observation, monitoring, and nursing care because of falls.

Patients with delirium require more nursing care than patients without delirium, regardless of the hospital setting. The delirium screening and (nursing) workload recording tools used in the eight studies showed a wide variation and, thus, limit standardized quantitative statements on nursing workload. The higher nursing workload of patients with delirium should be considered prospectively in nursing staff planning. In addition to the increased nursing workload, increased workloads for other health professional groups can also be assumed.