title: Feasibility and Effectiveness of a Delirium Prevention Bundle in Critically Ill Patients.
abstract: Strategies for preventing delirium include early identification and avoiding or modifying patient, environmental, and iatrogenic factors. Minimal research exists on a prescriptive delirium prevention bundle that details elements or strategies for each bundle component. Even less research has been focused on nurse-driven interventions or components.
  
  
  
  To evaluate the effectiveness of a delirium prevention bundle in decreasing delirium incidence in 2 medical-surgical intensive care units in a large Texas medical center.
  
  
  
  Researchers used the Confusion Assessment Method for the Intensive Care Unit to assess delirium incidence by using a controlled interventional cohort design with 447 delirium-negative critically ill patients. Bundle components consist of sedation cessation, pain management, sensory stimulation, early mobilization, and sleep promotion.
  
  
  
  The intervention, analyzed by using a logistic regression model, reduced the odds of delirium by 78% (odds ratio, 0.22; P = .001).
  
  
  
  The delirium prevention bundle was effective in reducing the incidence of delirium in critically ill medical-surgical patients. Further validation studies are under way.
authors.affiliation: Claudia DiSabatino Smith was director of nursing research, CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, Texas, when the study was done. She has since retired. Petra Grami is a manager of patient care, CHI St Luke's Health-Baylor St Luke's Medical Center. crdsmith@hotmail.com.
authors.forename: Claudia DiSabatino
authors.initials: CD
authors.lastname: Smith
authors.affiliation: Claudia DiSabatino Smith was director of nursing research, CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, Texas, when the study was done. She has since retired. Petra Grami is a manager of patient care, CHI St Luke's Health-Baylor St Luke's Medical Center.
authors.forename: Petra
authors.initials: P
authors.lastname: Grami
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D003693:Delirium / Q000517:prevention & control*; D004434:Early Ambulation / Q000451:nursing; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000451:nursing; D064872:Patient Care Bundles / Q000451:nursing*; D012890:Sleep