Patient Agitation in the Intensive Care Unit: A Concept Analysis.
Anne Mette N Adams, Diane Chamberlain, Charlotte Brun Thorup and 5 others
PMID 40277282WHAT IT FOUND
ICU agitation is defined by excessive movement, emotional tension, resisting care, and cognitive impairment, often with aggression or vital sign changes.
It is distinct from delirium and anxiety. Nurses should assess for these specific attributes and underlying causes before sedating, as agitation is not simply a need for more sedation.
Key findings
01Agitation is characterised by four core attributes: excessive motor activity, emotional tension, disruption of care, and cognitive impairment.
02Agitation is distinct from delirium, anxiety, and aggression; many delirious patients are hypoactive and agitation can occur without delirium.
03Existing sedation-agitation scales (like RASS) lack detailed definitions and may incorrectly imply that more sedation is the solution to agitation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The literature search was not exhaustive (limited to three databases, no grey literature). The study did not critically appraise the quality of the included sources. Many included studies relied on the same primary research, potentially overestimating the breadth of evidence. The model case is fictional, based on the authors' previous experience, not real patient data.
Declared interests
The authors declare no conflicts of interest. No external funding is reported for this specific analysis.
The easy way to misread this
Do not interpret this paper as evidence that agitation is caused by delirium or that sedation is the primary treatment. The analysis explicitly states that agitation can occur without delirium and that relying solely on sedation-agitation scales may lead to inappropriate management by focusing on symptoms rather than underlying causes like pain or unmet needs.