Environmental Intervention on Delirious Patients

Purpose: Delirium occurs among patients in intensive care unit at high rates and increases the risk for morbidity and mortality. The purpose of this study is to investigate the effects of environmental interventions for the prevention of delirium.

Methods: A total of 192 patients who had been admitted to the surgical intensive care unit (SICU) in Asan Medical Center during the pre-intervention period (Jun 2013 to Oct 2013) and the post-intervention period (Jun 2014 to Oct 2014) was enrolled and prospective cohort study was done. The environmental intervention included cognitive assessment, providing orientation and comfortable environment, and a proper sleeping environment. The primary outcomes were the incidence rate of delirium, time of delirium onset, and the duration of delirium.

Inclusion criteria

• with an age of 18 years or older
• who understood the purpose of this study and agreed to participate
• stayed in the SICU for a period of 48 hours or longer

Exclusion criteria

• who remained unresponsive [defined as the Richmond Agitation-Sedation Scale (RASS) less than -4]
• who could not measure Confusion Assessment Method (CAM-ICU) due to severe visual or hearing disturbance
• who had a history of severe psychiatric or neurologic deficit
• who required an isolation room due to transplantation or immunologic compromise
• who were discharged from ICU within 48 hours
• who were re-admitted to the ICU
• who were less than 18 years old
• who were admitted to the Surgical ICU through another ICU