Effects of A Multicomponent Intervention Program for Preventing Delirium in Geriatric Patients in the Intensive Care Unit

Abstract

Purpose: This study aimed to investigate the effects of a Multicomponent Intervention Program for Preventing Delirium (MIPPD) on the incidence of delirium, self-extubation or self-removal of the catheter, and length of stay among elderly patients in the Intensive Care Unit (ICU). Methods: This study employed a nonequivalent control group pretest-posttest non-synchronized design to verify the MIPPD effects. The participants, 73 patients aged over 65 years were admitted to a university hospital's ICU in J province between December 2015 and July 2016. The MIPPD contained the following elements: family caregiver education, delirium assessment, reorientation activities, therapeutic communication, sensory intervention for vision and hearing impairments, management of immobility or limited mobility, family support, and maintenance of sleeping patterns. Under the program, nurses and family members provided immediate intervention to elderly patients with an expected length of stay of at least 48 hours. Results: After the MIPPD application, the incidence of delirium in the intervention group was significantly lower (odds ratio=0.19, 95% confidence interval=0.03~0.97) than that in the control group. However, there were no significant differences between the groups in terms of self-extubation or catheter self-removal and length of stay. Conclusions: This program can effectively reduce the incidence of delirium. Because prevention is optimal for delirium management, a proactive intervention must be considered; given that, in this study, there were no problems in terms of family engagement, an MIPPD involving family participation should be actively implemented in intensive care unit practice.