title: Agitation onset, frequency, and associated temporal factors in critically ill adults.
abstract: BACKGROUND
  Agitation is a frequent complication in critically ill adults, can result in life-threatening events for patients or care providers, and extends the hospital length of stay, thereby increasing hospital costs.
  
  
  OBJECTIVE
  To describe the incidence, onset, and temporal factors related to agitation in critically ill adults.
  
  
  METHODS
  Data were collected for the first 5 days of stay of all adult patients consecutively admitted to a medical respiratory intensive care unit and a surgical trauma intensive care unit during a 2-month period. Agitation was documented by using scores on the Richmond Agitation-Sedation Scale or notation of agitation in the medical record. The hour was used as the documentation epoch, and data were summarized by hour, 4-hour block, and day for each patient.
  
  
  RESULTS
  Data were collected on 200 patients, 100 from each unit. Among the sample, 118 (59%) were agitated at some time during the 5 days. The overall agitation rate was 7.8% of the total hourly time. Mean onset of agitation was 11.6 hours from time of admission to the unit. Of the 118 patients who were agitated at some time, 102 (86%) had agitation on day 1. Compared with patients in the surgical trauma unit, patients in the medical respiratory unit had significantly more hours of agitation the first day and first hour of admission and significantly earlier onset of agitation.
  
  
  CONCLUSIONS
  Agitation was present in more than one-half of the patients in the sample, typically developed on the first day, and involved consecutive days.
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center School of Nursing in Houston, Texas. Mary Jo Grap is Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is associate dean for research and innovation and a professor, University of South Florida, College of Nursing, Tampa, Florida. Christine M. Schubert is an assistant professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio. burkrv@gmail.com.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Burk
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center School of Nursing in Houston, Texas. Mary Jo Grap is Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is associate dean for research and innovation and a professor, University of South Florida, College of Nursing, Tampa, Florida. Christine M. Schubert is an assistant professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Grap
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center School of Nursing in Houston, Texas. Mary Jo Grap is Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is associate dean for research and innovation and a professor, University of South Florida, College of Nursing, Tampa, Florida. Christine M. Schubert is an assistant professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Munro
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center School of Nursing in Houston, Texas. Mary Jo Grap is Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is associate dean for research and innovation and a professor, University of South Florida, College of Nursing, Tampa, Florida. Christine M. Schubert is an assistant professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Schubert
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center School of Nursing in Houston, Texas. Mary Jo Grap is Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is associate dean for research and innovation and a professor, University of South Florida, College of Nursing, Tampa, Florida. Christine M. Schubert is an assistant professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Curtis N
authors.initials: CN
authors.lastname: Sessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000453:epidemiology*; D012124:Respiratory Care Units / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult