Recently, The American College of Critical Care Medicine provided new guidelines for treating pain, agitation, and delirium in the ICU, in which detection and standardized treatment of pain are important issues. By implementing these new guidelines…
ID
Bron
Aandoening
Treatment of critically ill patients in the ICU is often complicated by the onset of delirium. Delirium is a psycho-organic disorder , characterized by an acute disturbance of consciousness and changes in cognition, often with a fluctuating course. Symptoms of delirium include change in level of awareness, decreased attention span, memory deficit, disorientation, language disturbance and hallucinations. Other symptoms commonly associated with delirium are confusion, agitation, apathy, anxiety, abnormal psychomotor activity, and sleep disturbance. The pathophysiology of delirium is poorly understood, but the onset of delirium is a serious complication. Delirium is an important independent predictor of negative clinical outcomes in ICU patients, including increased mortality, longer ICU stay, higher costs of care and long-term cognitive impairment.
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Delirium incidence
Achtergrond van het onderzoek
Recently, The American College of Critical Care Medicine provided new guidelines for treating pain, agitation, and delirium in the ICU, in which detection and standardized treatment of pain are important issues. By implementing these new guidelines in our ICU, we expect an improved prognosis of patients and possibly a decrease in the incidence of delirium.
Doel van het onderzoek
Recently, The American College of Critical Care Medicine provided new guidelines for treating pain, agitation, and delirium in the ICU, in which detection and standardized treatment of pain are important issues. By implementing these new guidelines in our Intensive Care Unit, we expect a reduction in the incidence of pain, and possibly also a decreased incidence of delirium. We present the following research question: Does the implementation of pain measurement instruments and standardized treatment of pain, improve the prognosis of patients in the ICU of the Atrium Medisch Centrum Parkstad, and will that lead to a decrease in the incidence of delirium?
Onderzoeksopzet
Pain detection: Numeric Rating Scale (NRS) or Critical Care Observation Score (CPOT) : 3x/day.
Monitoring depth of sedation: Richmond Agitation-Sedation Scale (RASS): 3x/day.
Detecting delirium: Confusion Assessment Method for the ICU (CAM-ICU): 3x/day.
Onderzoeksproduct en/of interventie
All ICU patients included in the study will be treated according to the new pain, agitation, and delirium guideline during 12 weeks (group A). Primary and secondary outcomes will be registered. Data will be compared with earlier results of patients in the ICU receiving care as usual (group B).
Publiek
Atrium Medisch Centrum Parkstad
Henri Dunantstraat 5
H.J.H. Bremer
Heerlen 6419 PC
The Netherlands
045-5766490
h.bremer@atriummc.nl
Wetenschappelijk
Atrium Medisch Centrum Parkstad
Henri Dunantstraat 5
H.J.H. Bremer
Heerlen 6419 PC
The Netherlands
045-5766490
h.bremer@atriummc.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
All patients admitted to the Intensive Care Unit of the Atrium Medisch Centrum Parkstad between November 2014 and February 2015 are treated according to latest Pain, Agitation, and Delirium guideline.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
-Age < 18 years
-Pre-existent delirium 24 hours before admittance to ICU
-Richmond Agitation Sedation Score (RASS) -4/-5 during ICU stay
-< 24 hours ICU stay
-Deafness or serious visual impairment
-Unable to speak or understand Dutch language
-Serious mental handicaps
-Pre-existent cognitive impairment or dementia
-Aphasia
-Delirium screening compliance rate <80% during ICU stay
Opzet
Deelname
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL4697 |
| NTR-old | NTR4902 |
| Ander register | : METC nr: 14-N-99 |