Non-pharmacological Treatment of Intensive Care Unit Delirium
American Journal of Nursing Science
Volume 8, Issue 3, June 2019, Pages: 119-128
Received: Mar. 21, 2019; Accepted: May 5, 2019; Published: May 29, 2019
Views 463      Downloads 235
Liu Ke, Department of Intensive Care Unit, People’s Hospital of Leshan, Leshan, China
Wang Jun, Department of Surgical, People’s Hospital of Leshan, Leshan, China
Ma Zhiqun, Department of Union President, People’s Hospital of Leshan, Leshan, China
Chen Bing, Department of Nursing Department, People’s Hospital of Leshan, Leshan, China
Wang Lijun, Department of Vascular, Pediatric, Anorectal Surgery, People’s Hospital of Leshan, Leshan, China
Gong Juan, Department of Intensive Care Unit, People’s Hospital of Leshan, Leshan, China
Wang Rui, Department of Intensive Care Unit, People’s Hospital of Leshan, Leshan, China
Article Tools
Follow on us
Objective: To understand whether non-pharmacological treatment can reduce intensive care units. Methods: A review was conducted by searching the literature in the CINAHL, PubMed, PsycINFO, and EMBASE database. The prevalence of sputum in the ICU is 16%-89%. It is characterized by short-term memory loss, disorientation and impaired attention. There are three types of sputum, including hyperactivity, hyperactivity, and mixing. Both pharmacology and non-pharmacology include ABCDE care bundles, sedation, early mobilization, promotion of personal sleep quality, reduced noise and artificial lighting, and patient education. Music therapy as a non-pharmacological intervention has not been fully studied. CONCLUSIONS: Non-pharmacological treatment of sputum in the ICU remains an effective method because it eliminates the use of sedatives. However, this depends on the health of the patient, such as vision and hearing impairment. Exploring the effectiveness of music therapy for this condition will help to further improve the multi-component approach, which requires a combination of non-pharmacological interventions to promote patient health.
Intensive Care Unit, Non-pharmacological, Delirium
To cite this article
Liu Ke, Wang Jun, Ma Zhiqun, Chen Bing, Wang Lijun, Gong Juan, Wang Rui, Non-pharmacological Treatment of Intensive Care Unit Delirium, American Journal of Nursing Science. Vol. 8, No. 3, 2019, pp. 119-128. doi: 10.11648/j.ajns.20190803.17
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Delaney, A. Hammond, N. and Litton, E, 2018. Preventing delirium in the intensive care unit. Jama, 319(7), pp. 659-660. doi: 10.4103/0974-2700.199520
Cavallazzi, R, Saad, M. and Marik, P. E, 2012. Delirium in the ICU: an overview. Annals of intensive care, 2(1), p. 49. doi: 10.1186/2110-5820-2-49
Laske, R. A. and Stephens, B, 2016. Delirium in critical care patients. Nursing2018 Critical Care, 11(1), pp. 18-23. doi: 10.1097/01.CCN.0000475514.04388.d9
Grover, S. and Avasthi, A, 2018. Clinical practice guidelines for management of delirium in elderly. Indian journal of psychiatry, 60 (Suppl 3), p. S329. doi: 10.4103/0019-5545.224473
Reade, M. C. and Finfer, S, 2014. Sedation and delirium in the intensive care unit. New England Journal of Medicine, 370(5), pp. 444-454. DOI: 10.1056/NEJMra1208705
Rivosecchi, R. M, Smithburger, P. L, Svec, S, Campbell, S. and Kane-Gill, S. L, 2015. Nonpharmacological interventions to prevent delirium: an evidence-based systematic review. Critical Care Nurse, 35(1), pp. 39-49. Accessed from
Patino, C. M. and Ferreira, J. C, 2018. Inclusion and exclusion criteria in research studies: definitions and why they matter. JornalBrasileiro de Pneumologia, 44(2), pp. 84-84. doi: 10.1590/S1806-37562018000000088
Ofir, Z, Schwandt, T, Duggan, C, and McLean, R, 2016. Research Quality Plus (RQ+): a holistic approach to evaluating research. Accessed February 20, 2019 from
Fazio, S, Pace, D, Flinner, J. and Kallmyer, B, 2018. The fundamentals of person-centered care for individuals with dementia. The Gerontologist, 58(suppl_1), pp. S10-S19. doi: 10.1093/geront/gnx122
Smith, C. D. and Grami, P, 2017. Feasibility and effectiveness of a delirium prevention bundle in critically ill patients. American Journal of Critical Care, 26(1), pp. 19-27. doi: 10.4037/ajcc2017374
Ibrahim, K, McCarthy, C. P, McCarthy, K. J, Brown, C. H, Needham, D. M, JanuzziJr, J. L. and McEvoy, J. W, 2018. Delirium in the cardiac intensive care unit. Journal of the American Heart Association, 7(4), p.e008568. Doi: 10.1161/JAHA.118.008568
Sona, C, 2009. Assessing delirium in the intensive care unit. Critical care nurse, 29(2), pp. 103-105. doi: 10.4037/ccn2009329
Arumugam, S, El-Menyar, A, Al-Hassani, A, Strandvik, G, Asim, M, Mekkodithal, A, Mudali, I. and Al-Thani, H, 2017. Delirium in the intensive care unit. Journal of emergencies, trauma, and shock, 10(1), p. 37. doi: 10.4103/0974-2700.199520
Brummel, N. E. and Girard, T. D, 2013. Preventing delirium in the intensive care unit. Critical care clinics, 29(1), pp. 51-65. doi: 10.1016/j.ccc.2012.10.007
Kim, Y. and Hong, S. J, 2015. Intensive Care Unit Delirium. Korean Journal of Critical Care Medicine, 30(2), pp. 63-72. Doi: 10.4266/kjccm.2015.30.2.63
Silverstein, J. H. and Deiner, S. G, 2013. Perioperative delirium and its relationship to dementia. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 43, pp. 108-115. doi: 10.1016/j.pnpbp.2012.11.005
Hayhurst, C. J, Pandharipande, P. P. and Hughes, C. G, 2016. Intensive Care Unit Delirium A Review of Diagnosis, Prevention, and Treatment. Anesthesiology: The Journal of the American Society of Anesthesiologists, 125(6), pp. 1229-1241. doi:10.1097/ALN.0000000000001378
King, J. and Gratrix, A, 2009. Delirium in intensive care. Continuing Education in Anaesthesia, Critical Care & Pain, 9(5). Doi: 10.1093/bjaceaccp/mkp023
The Ohio State University, 2013. Prevention and Management of Delirium in the ICU. Wexner Medical Center. Accessed February 20, 2019 from
Barr, J, Fraser, G. L, Puntillo, K, Ely, E. W, Gélinas, C, Dasta, J. F, Davidson, J. E, Devlin, J. W, Kress, J. P, Joffe, A. M. and Coursin, D. B, 2013. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical care medicine, 41(1), pp. 263-306. Doi:10.1097/CCM.0b013e3182783b72
Roca, C. M, 2015. A Quantitative Study of the Effectiveness of the Nurse-Led Delirium Protocol on Hospitalized Older Adults Utilizing the Confusion Assessment Method (CAM) (Doctoral dissertation). Retrieved from
Ista, E, Trogrlic, Z, Bakker, J, Osse, R. J, van Achterberg, T. and van der Jagt, M, 2014. Improvement of care for ICU patients with delirium by early screening and treatment: study protocol of iDECePTIvE study. Implementation Science, 9(1), p. 143. doi: 10.1186/s13012-014-0143-7
Palacios-Ceña, D, Cachón-Pérez, J. M, Martínez-Piedrola, R, Gueita-Rodriguez, J, Perez-de-Heredia, M. and Fernández-de-las-Peñas, C, 2016. How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups. BMJ open, 6(1), p.e009678. doi: 10.1136/bmjopen-2015-009678
Anbu, A. S, 2014. An evaluation of nursing practices regarding delirium assessments in adult critical care units in Western seaboard region of Ireland (Doctoral dissertation). Accessed from;jsessionid=FD0268F7CE17A6928DA4EC174CA7FE12?sequence=1
Mori, S, Takeda, J. R. T, Carrara, F. S. A, Cohrs, C. R, Zanei, S. S. V. and Whitaker, I. Y, 2016. Incidence and factors related to delirium in an intensive care unit. Revista da Escola de Enfermagem da USP, 50(4), pp. 587-593. Doi: 10.1590/S0080-623420160000500007 NICE, 2010. Delirium: Prevention, Diagnosis, and Management. Clinical Guideline. Accessed February 20, 2019 from
Park, J, Oh, S. T, Park, S, Choi, W. J, Shin, C. S, Na, S. H, Kim, J. J, Oh, J. and Park, J. Y, 2018. The Effects of a Delirium Notification Program on the Clinical Outcomes of the Intensive Care Unit: A Preliminary Pilot Study. Acute and Critical Care, 33(1), pp. 23-33. Doi: 10.4266/acc.2017.00584
Dizon, M. L, 2016. The Effect of Music Intervention on CAM Scores of Hospitalized Older Adults Experiencing Delirium. Masters Theses and Graduate Research. Accessed February 22, 2019 from
Cheong, C. Y, Tan, J. A. Q, Foong, Y. L, Koh, H. M, Chen, D. Z. Y, Tan, J. J. C, Ng, C. J. and Yap, P, 2016. Creative music therapy in an acute care setting for older patients with delirium and dementia. Dementia and geriatric cognitive disorders extra, 6(2), pp. 268-275. Doi: 10.1159/000445883
Abraha, I, Trotta, F, Rimland, J. M, Cruz-Jentoft, A, Lozano-Montoya, I, Soiza, R. L, Pierini, V, Fulgheri, P. D, Lattanzio, F, O’Mahony, D. and Cherubini, A, 2015. Efficacy of non-pharmacological interventions to prevent and treat delirium in older patients: a systematic overview. The SENATOR project ONTOP Series. PloS one, 10(6), p.e0123090. Doi: 10.1371/journal.pone.0123090
Cunningham, J. and Kim, L. D, 2018. Post-operative delirium: a review of diagnosis and treatment strategies. Journal of Xiangya Medicine, 3(2). Accessed from
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186