The frequency of sepsis-associated delirium in intensive care unit and its effect on nurse workload.
Şerife Alıcı, Ayşegül Öztürk Birge
PMID 38822493WHAT IT FOUND
ICU patients with sepsis-associated delirium had 1.8 hours more average nurse care time than patients without it.
Delirium alone had 1.1 hours more care time and sepsis alone had 1.3 hours more, but this is association, not cause.
Key findings
01Sepsis-associated delirium was found in 10.1% of patients, delirium in 39.9%, and sepsis in 12.7%.
02Patients with sepsis-associated delirium had 1.8 hours more average nurse care time than patients without it.
03The presence of sepsis-associated delirium explained 22.8% of the variance in the nurse workload score.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and correlational, so it cannot show that sepsis-associated delirium causes higher nurse workload. Only 16 patients had sepsis-associated delirium, so findings specific to that group are based on a small number. The unit did not routinely use tools to evaluate sepsis and delirium, so it was hard to know which condition developed first. Delirium assessments were done during morning and evening shifts but not during the 24:00 to 08:00 shift. Fluctuating delirium symptoms may be missed during night shifts. The study did not account for medication types, dosages, or durations used in chemical restraints. It was done in one ICU in Turkey, and the nurse-patient ratio was 1/2, so results may not apply to other units. Patient outcomes, such as mortality, length of stay, or quality of care, were not measured.
The easy way to misread this
Do not read the 1.8-hour difference as proof that sepsis-associated delirium causes higher nurse workload. The study was correlational, and workload was also linked to illness severity and treatments such as vasopressors and mechanical ventilation.