Effect of family reorientation messages on delirium prevention among critically ill patients

Abstract

Background: About 50%-80% of critically ill patients develop delirium during their intensive care unit (ICU) stay. Adverse events associated with delirium can range from functional disability, cognitive and psychological impairment, dementia and even death. Removal of invasive lines, self-extubation, prolonged sedation and ventilation therapies which delay the ICU liberation, and increase the overall hospital length of stay are also negative squeals of delirium. Delirium has series of adverse events that are not limited to the associated morbidies and mortality, but also extended to include the burden placed on caregivers, families and healthcare services, in addition to increasing the cost of care. Using auditory stimulation as a non-pharmacological intervention can stimulate the affected neural networks, accelerate brain plasticity and avoid sensory deprivation that could induce pain, agitation, and delirium and slow down the patients' recovery. It is evident that familiar auditory stimuli by a familiar voice is eliciting more responses to auditory tones as it can grasp patients' attention without much effort and disrupts ongoing cognitive activities. Accordingly, multicomponent family reorientation strategy has recently been proposed to achieve better outcomes.

Methods: A quasi experimental research design was used in this study in which one tool was used for data collection: “Confusion Assessment Method-intensive care unit (CAM-ICU)”. 

Results: During the five-day intervention period, the delirium free days was all the days in the family voice group, four days in the unfamiliar voice group and no free days in the control group which indicates a significant difference among groups on number of delirium free days (^MCp < .001*).

Conclusion: Reorienting critically ill patients through recorded messages is an effective strategy to reduce the incidence of delirium. Furthermore, using a familiar family sound is more effective in reducing delirium as proved by the number of delirium free days. During the five-day intervention period, the family voice group shows more delirium free days than the unfamiliar voice group. The intervention used in this study is easy, costless and effective strategy in prevention of delirium among critically ill patients.