Registered Nurses´ Association of Ontario
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Practice Recommendations for Delirium
| Recommendation |
|---|
| 1.1 Nurses should maintain a high index of suspicion for the prevention, early recognition and urgent treatment of delirium to support positive outcomes. |
| 1.2 Nurses should use the diagnostic criteria from the Diagnostic and Statistical Manual (DSM) IV-R to assess for delirium, and document mental status observations of hypoactive and hyperactive delirium. |
| 1.3 Nurses should initiate standardized screening methods to identify risk factors for delirium on initial and ongoing assessments. |
| 1.4 Nurses have a role in prevention of delirium and should target prevention efforts to the client‘s individual risk factors. |
| 1.5 In order to target the individual root causes of delirium, nurses working with other disciplines must select and record multicomponent care strategies and implement them simultaneously to prevent delirium. |
| 1.5.1 Consultation/Referral Nurses should initiate prompt consultation to specialized services. |
| 1.5.2 Physiological Stability/Reversible Causes Nurses are responsible for assessing, interpreting, managing, documenting and communicating the physiological status of their client on an ongoing basis. |
| 1.5.3 Pharmacological Nurses need to maintain awareness of the effect of pharmacological interventions, carefully review the older adults’ medication profiles, and report medications that may contribute to potential delirium. |
| 1.5.4 Environmental Nurses need to identify, reduce, or eliminate environmental factors that may contribute to delirium. |
| 1.5.5 Education Nurses should maintain current knowledge of delirium and provide delirium education to the older adult and family. |
| 1.5.6 Communication/Emotional Support Nurses need to establish and maintain a therapeutic supportive relationship with older adults based on the individual’s social and psychological aspects. |
| 1.5.7 Behavioural Interventions Nurses are responsible for the prevention, identification and implementation of delirium care approaches to minimize disturbing behaviour and provide a safe environment. Further, it is recommended that restraints not be used./td> |
| 1.6 Nurses must monitor, evaluate, and modify the multi-component intervention strategies on an ongoing basis to address the fluctuating course associated with delirium. |
