Section Four
PREVENTION OF DELIRIUM
Approx Time To Complete: 15 Mins
Stephanie Craig Talks About Preventing Delirium
Implementing effective prevention strategies is crucial for improving patient outcomes and minimising the impact of delirium. The following comprehensive approach, based on established guidelines, addresses various factors contributing to delirium, promoting a person-centred and evidence-based approach to prevention.
Ten Top Tips for Preventing Delirium
Tip 1: Person-Centred Care Team
Fostering a stable and familiar environment is foundational to delirium prevention. By ensuring that individuals at risk of delirium are cared for by a consistent team of healthcare professionals, unnecessary moves within and between wards or rooms are minimised. The rationale behind this approach lies in the understanding that a stable care team provides familiarity and reassurance, mitigating the risk of disorientation and anxiety that can contribute to delirium onset or exacerbation.
Tip 2: Tailored Multicomponent Intervention
An early and personalised intervention is pivotal in preventing delirium. Within 24 hours of admission, a comprehensive assessment is conducted to identify clinical factors contributing to delirium risk.
This timely evaluation enables healthcare providers to tailor a multicomponent intervention package to address individual needs. The rationale behind this approach is rooted in the recognition that early and targeted interventions can effectively mitigate the risk factors associated with delirium. The intervention is carried out by a multidisciplinary team trained and competent in delirium prevention. This collaborative approach leverages the expertise of various healthcare professionals, ensuring a well-rounded and effective preventive strategy.
By bringing together professionals from diverse backgrounds, each contributing unique insights, the intervention is more likely to address the complexity of factors leading to delirium.
Tip 3: Addressing Cognitive Impairment and Disorientation
Creating an environment that supports cognitive well-being is crucial in delirium prevention. Adequate lighting, clear signage, visible clocks, and calendars are essential components of environmental modifications. Additionally, regular communication to reorient individuals about their surroundings, accompanied by cognitively stimulating activities and visits from family and friends, contributes to a supportive and familiar atmosphere. This approach recognises that addressing cognitive impairment and disorientation through environmental adjustments and social interactions can significantly reduce the risk of delirium.
Tip 4: Addressing Dehydration and Constipation
Hydration and nutrition play a vital role in preventing delirium. Encouraging adequate fluid intake, with considerations for subcutaneous or intravenous fluids, if necessary, helps prevent dehydration. It is essential to manage fluid balance carefully, especially in individuals with comorbidities such as heart failure or chronic kidney disease. This approach recognises the impact of dehydration and constipation on cognitive function and aims to address these factors proactively.
Tip 5: Assessing for Hypoxia and Infection Control
Hypoxia and infection are potential contributors to delirium and require specific attention. Careful assessment and optimisation of oxygen saturation are undertaken, considering the limitations of pulse oximeters. Addressing infection involves vigilant monitoring, timely treatment, and infection control procedures aligned with guidelines. This preventive strategy aims to identify and manage factors that can trigger or worsen delirium, emphasising the importance of a proactive and systematic approach.
Tip 6: Addressing Immobility or Limited Mobility
Encouraging mobility is a key component of preventing delirium, particularly in the post-surgery period. Early mobilisation and walking, with appropriate aids, if necessary, are recommended for all individuals, including those unable to walk. Active range-of-motion exercises are promoted to mitigate the adverse effects of immobility. This approach recognises the link between physical activity and cognitive well-being, emphasising the importance of maintaining mobility as a preventive measure.
Tip 7: Addressing Pain and Medication Review
Pain management and medication review are integral components of delirium prevention. Assessing pain, especially in individuals with communication difficulties, and initiating appropriate pain management are essential steps. Medication review, considering both the type and number of medications, helps identify and address potential contributors to delirium. The rationale behind this approach lies in recognising that untreated pain and complex medication regimens can adversely impact cognitive function, emphasising the need for a tailored and vigilant approach.
Tip 8: Addressing Poor Nutrition and Sensory Impairment
Nutritional support and sensory impairment management are crucial in preventing delirium. Following guidelines on nutrition support for adults, ensuring proper denture fit, and addressing sensory impairments contribute to overall well-being. This preventive strategy recognises the impact of nutrition and sensory experiences on cognitive function, highlighting the importance of holistic care.
Tip 9: Promoting Good Sleep Patterns and Hygiene
Quality sleep is vital for cognitive well-being, and disturbances in sleep patterns can contribute to delirium. Avoiding medical procedures during sleeping hours, scheduling medication rounds to minimise sleep disruption, and reducing noise during sleep periods are essential preventive measures. This approach acknowledges the connection between sleep hygiene and cognitive function, emphasising the role of a conducive sleep environment in delirium prevention.
Tip 10: Promoting Social Engagement and Cognitive Stimulation
Encouraging social engagement and cognitive stimulation is a valuable component of delirium prevention. Regular interaction with peers, family, and friends helps maintain social connections, reducing feelings of isolation and loneliness that can contribute to delirium. Incorporating cognitive stimulation activities, such as puzzles, games, or reminiscence therapy, fosters mental engagement and resilience. This approach recognises the importance of social and cognitive well-being in preventing delirium, emphasizing the positive impact of meaningful activities on overall mental health.
In conclusion, a holistic and person-centred approach is fundamental to preventing delirium. By addressing various contributing factors through a multidisciplinary team and tailored interventions, healthcare providers can create an environment that supports cognitive well-being and minimises the risk of delirium onset or exacerbation.
Recognising the interconnected nature of physical, environmental, and social factors, this comprehensive approach aims to optimize patient outcomes and enhance the overall quality of care.
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