The implementation and evaluation of a family-led novel intervention for delirium prevention and management in adult critically ill patients: A mixed-methods pilot study.
Gideon U Johnson, Amanda Towell-Barnard, Christopher McLean and 1 others
PMID 39617957WHAT IT FOUND
No adverse reactions were reported when 15 mechanically ventilated ICU patients received recorded family voice messages, and median RASS was -1.
Nurses found it acceptable, but this small pilot did not test delirium prevention.
Key findings
01All 15 enrolled patients completed the recorded family voice intervention, with no adverse reactions reported, and the median intervention frequency was 2.3 times per day.
02Five patients achieved a RASS score of 0, and three patients improved from +1 to 0 by the end of the study.
03Qualitative themes included acceptance and nurse descriptions of improved alertness, but some nurses were unsure how to identify delirium.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Fifteen patients is too small to test effectiveness. All patients received the intervention alongside usual ICU care and sedation, so RASS changes cannot be separated from other treatment. The primary measure was RASS, not CAM-ICU or delirium incidence, so it did not directly test delirium prevention. Training was not standardized across all nurses. Only three patient participants were interviewed after discharge. The study was conducted in one UK ICU context, limiting transferability.
Declared interests
The paper reports support from an Australian Government Research Training Program Scholarship and ethics/registration approvals. No commercial sponsor or author conflict-of-interest statement is given.
The easy way to misread this
Do not read the RASS improvements or nurse comments as proof that family voice messages prevent or treat delirium. This was a small pilot using RASS rather than a delirium-specific measure, and the authors describe it as preliminary work for a future randomized trial.