Delirium is a state of mental confusion that affects up to 80%1 of patients admitted to the ICU each year. It’s a terrifying experience for the patient –and for the family.
Reducing the number of delirium cases can help support hospitals in their efforts to improve clinical and economic outcomes and manage care in line with the Quadruple Aim.
ICU delirium can have a profound impact on patients, their families and healthcare costs.
Delirium increases mortality both in intensive care units and after discharge from the hospitall,2. Patients surviving delirium have a higher risk of permanent cognitive impairment such as dementia1and options for pharmacological treatment are limited3.
This condition now surpasses diabetes as a leading source of healthcare costs in the US.10
Acute Brain Dysfunction and Its Consequences
Delirium is the most common dysfunction of the brain in intensive care units, occurring in 30 to 80 percent of patients.1,2 The development of delirium during intensive care treatment can lead to long-term cognitive disorders and has significant effects on both the clinical and financial outcome.1,2,3 Although there is an increasing focus on delirium in intensive care medicine, the condition of delirium goes still often undetected.
Increased Risk of Mortality
Delirium doubles the risk of mortality in the ICU, and triples the risk in the first six months after discharge from hospital.1,2 There is also a nine times higher risk for delirious patients to develop a permanent cognitive impairment.2
High Costs and Inefficient Resource Utilization
It is estimated that delirium costs $145 billion a year in the United States alone making delirium a huge burden for the healthcare system.10 Since delirium prolongs length of stay in the ICU by five to ten days, it may also contribute to inefficient use of resources.1
Alert patients actively participating in their own healing process
More and more international delirium guidelines (such as the PAD guideline in the US, the German DAS guideline, and the NICE delirium guideline in the UK) postulate that patients in intensive care shall be awake, alert and free of pain, anxiety and delirium, to be able to participate in their healing process actively.4,5,6 This implies that sedation of patients should be minimized and they should be systematically monitored for analgesia, sedation, delirium, anxiety, stress, and sleep. Non-pharmacological measures are considered particularly effective in the prevention of delirium, and therefore recommended to be implemented for all critically ill patients.5
With
Components developed by Philips as part of the VitalMinds delirium management bundle are based on international delirium guidelines 4,5,6. Available solution components are Philips Ambience Analysis, a light and sound quick scan, Philips VitalSky aclinical light therapy system and Philips Delirium Management Maturity Assessment to help gain insights in the current maturity of delirium management.
Philips Ambience Analysis
Light and sound are essential factors in providing an ICU environment that is supportive of patient health and recovery, including the prevention of delirium 7,8. The Ambience Analysis service provides measurements of light and sound conditions in the ICU patient environment in a consistent and defined way over a period of one month. The insights gained with Ambience Analysis quick scan serve as a basis for improving and managing light and sound conditions for the patient environment.
Philips Delirium Management Maturity Assessment
Assessing the level of maturity in delirium management is an important step towards achieving your delirium management goals.
The Philips Delirium Management Maturity Assessment service can help provide insights into the current status of implementation of delirium guidelines in your hospital. It helps to create a baseline for improvements and supports development of a successful delirium management program.
Philips VitalSky
As one of the key components of the VitalMinds multi-component approach, Philips has developed the VitalSky medical system. VitalSky provides a clinical light therapy, to help prevent delirium by enhancing and synchronizing the circadian rhythm in critically ill patients. In addition to the clinical light therapy VitalSky supports patients with time orientation and provides a calming and pleasant environment. VitalSky also integrated three superior quality workplace lighting features, supporting efficient care delivery without disturbing the patients.
1 Ouimet et al., Intensive Care Med (2007) 33(1):66-73
2 Ely et al., JAMA (2004) 291(14):1753-62
3 Vardi et al., R I Med J (2013) 97(6):24-8
4 Barr et al., Crit Care Med. 2013 41(1):263-306
5 DAS Taskforce 2015, Ger Med Sci 2015;13: Doc19
6 NICE, https://www.nice.org.uk/guidance/qs63
7 Kamdar et al., Crit Care Med. 2013 41(3):800-9
8 Patel et al., Anaesthesia. 2014 69(6):540-9
9 Ely, Crit Care Med. 2017 45(2):321-330
10 Leslie et al., Arch Intern Med. (2008) 168(1):27-32
11 Lütz et al., Clin Health Promot 2016; 6(1):5-12
