학술논문

Retrospective evaluation of a delirium order set utilizing nonpharmacologic and pharmacologic interventions for the treatment of delirium in medical intensive care unit patients.
Document Type
Article
Source
American Journal of Health-System Pharmacy. 2022 Supplement, Vol. 79, pS33-S42. 10p. 1 Diagram, 2 Charts.
Subject
*INTENSIVE care units
*PILOT projects
*RETROSPECTIVE studies
*DELIRIUM
*LONGITUDINAL method
*VALPROIC acid
*ANTIPSYCHOTIC agents
Language
ISSN
1079-2082
Abstract
Purpose To describe the use of a medical intensive care unit (MICU) delirium order set pilot and its associated impact on utilization of nonpharmacologic and pharmacologic interventions, pharmacologic continuation at transitions of care, and resolution of ICU delirium. Methods This was a retrospective cohort analysis of MICU patients who received delirium management using an order set pilot compared to standard care. Patients 18 years of age or older admitted to the MICU between May 2019 and January 2020 who received an antipsychotic or valproic acid for the treatment of delirium were included. Results Pharmacologic treatment continuation past ICU discharge occurred in 30% of patients in the pilot cohort (n = 50) compared to 54% of patients receiving standard care (n = 50; P = 0.027). On treatment days 1 through 7, utilization of deliriogenic medications was significantly lower in the pilot cohort (78% vs 96%, P = 0.007). No differences were observed between the groups in delirium resolution, delirium recurrence, hospital and ICU length of stay, or mortality. Conclusion A MICU order set prioritizing nonpharmacologic management and limiting the duration of pharmacologic agents for delirium may aid providers in the management of ICU delirium and reduce exposure to pharmacologic interventions. [ABSTRACT FROM AUTHOR]