Article
Implementation of delirium monitoring according to the German S3-Guidelines for the management of analgesia, sedation and delirium in intensive care
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Published: | July 10, 2012 |
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Background: Delirium is seen in 11 to 87% of the ICU patients. It is associated with a threefold risk of dying within 6 months after ICU discharge and a worse cognitive outcome.
Objectives: The primary aim of the study was to investigate the implementation rate of delirium monitoring in ICU patients according to the German S3-Guideline (register number 001-012).
Methods: The study was designed as an anonymous international multicenter clinical survey. The data assessment was performed with 2 different online questionnaires. Repeated email invitations were sent to all members of the European Society of Intensive Care Medicine (ESICM). All ICUs were eligible for taking part in the study. Descriptive statistics were computed for all study variables using Aabel v3.0.6, Gigawiz Ltd. Co.
Results: A majority of the ICUs, 55% (56 of 101), reported some kind of screening for symptoms of delirium. Of those that did screen for delirium, 78% (44 of 56) used a validated assessment tool: CAM-ICU (n=37, 84%) > ICDSC > Nu-DESC / DDS. Antipsychotics (n=86, 85%) and benzodiazepines (n=81, 80%) were the two categories of medications most commonly chosen by the healthcare professionals to manage delirum.
Discussion: The data reflect an increasing awareness for delirium monitoring amongst intensivits. This may partially explain the increased implentation rates of specific delirium assessment tools measured in this survey.
Implications for guideline developers/users: This survey indicates, that knowledge regarding delirium management has improved. National and international guidelines are important instruments to integrate current best evidence from research with clinical policy and practice.