Delirium and sedation in the intensive care unit: survey of behaviors and attitudes of 1384 healthcare professionals.
OBJECTIVE
A 2001 survey found that most healthcare professionals considered intensive care unit (ICU) delirium as a serious problem, but only 16% used a validated delirium screening tool. Our objective was to assess beliefs and practices regarding ICU delirium and sedation management.


METHODS
Between October 2006 and May 2007, a survey was distributed to ICU practitioners in 41 North American hospitals, seven international critical care meetings and courses, and the American Thoracic Society e-mail database.


METHODS
A convenience sample of 1384 healthcare professionals including 970 physicians, 322 nurses, 23 respiratory care practitioners, 26 pharmacists, 18 nurse practitioners and physicians' assistants, and 25 others.


RESULTS
A majority [59% (766 of 1300)] estimated that more than one in four adult mechanically ventilated patients experience delirium. More than half [59% (774 of 1302)] screen for delirium, with 33% of those respondents (258 of 774) using a specific screening tool. A majority of respondents use a sedation protocol, but 29% (396 of 1355) still do not. A majority (76%, 990 of 1309) has a written policy on spontaneous awakening trials (SATs), but the minority of respondents (44%, 446 of 1019) practice spontaneous awakening trials on more than half of ICU days.


CONCLUSIONS
Delirium is considered a serious problem by a majority of healthcare professionals, and the percent of practitioners using a specific screening tool has increased since the last published survey data. Although most respondents have adopted specific sedation protocols and have an approved approach to stopping sedation daily, few report even modest compliance with daily cessation of sedation.
Patel
Rina P
RP
School of Medicine (RPP), Vanderbilt University School of Medicine, Nashville, TN, USA.
Gambrell
Meredith
M
Speroff
Theodore
T
Scott
Theresa A
TA
Pun
Brenda T
BT
Okahashi
Joyce
J
Strength
Cayce
C
Pandharipande
Pratik
P
Girard
Timothy D
TD
Burgess
Hayley
H
Dittus
Robert S
RS
Bernard
Gordon R
GR
Ely
E Wesley
EW
D001291:Attitude of Health Personnel; D016292:Procedural Sedation; D003693:Delirium / Q000175:diagnosis / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units