Delirium: A Comprehensive Review for Nursing Diagnosis, Management, and Intervention Controls

Abstract

Background: Delirium is an acute neuropsychiatric syndrome characterized by altered attention, consciousness, and cognitive function, often affecting elderly individuals. It arises from underlying medical conditions and is associated with significant morbidity, mortality, and healthcare costs. The condition is multifactorial, with predisposing and precipitating factors contributing to its onset. Despite its clinical importance, delirium is frequently underdiagnosed, particularly in its hypoactive form, leading to delayed intervention and poor outcomes.

Aim: This review aims to provide a comprehensive overview of delirium, focusing on its diagnosis, management, and intervention strategies. It emphasizes the importance of early detection, multidisciplinary collaboration, and evidence-based approaches to improve patient outcomes.

Methods: The review synthesizes current literature on delirium, including its pathophysiology, risk factors, diagnostic criteria, and management strategies. It highlights the use of validated assessment tools such as the Confusion Assessment Method (CAM) and discusses non-pharmacologic interventions, including the Hospital Elder Life Program (HELP). Pharmacologic treatments are explored in specific contexts, such as hyperactive delirium and substance withdrawal.

Results: Delirium is a complex condition requiring a multifaceted approach for effective management. Non-pharmacologic interventions, such as environmental modifications, reorientation strategies, and sleep promotion, are foundational. Pharmacologic treatments, primarily antipsychotics, are reserved for severe cases. Early detection and prevention are critical, as delirium is associated with prolonged hospital stays, increased mortality, and significant healthcare costs.

Conclusion: Delirium is a serious yet often preventable condition that necessitates a proactive, interprofessional approach. Early identification, targeted interventions, and continuous monitoring are essential to mitigate its impact. While pharmacologic treatments have limited roles, non-pharmacologic strategies remain the cornerstone of management. Future research should focus on refining diagnostic tools and exploring effective pharmacologic options.