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Patients with delirium have changes in their thinking and are often confused and cannot pay attention. About half of patients in an intensive care unit (ICU) have delirium during their stay. Research has shown that patients with delirium are more likely to die or to have long-term brain problems, including posttraumatic stress disorder, depression and other mental health issues, than those without delirium. Although nurses and doctors have tools to measure delirium in the ICU, it can be hard to identify and, in some cases, may be missed. Family members may be the first to notice that their loved ones have changes in their thinking or cannot pay attention. There are tools called the Family Confusion Assessment Method (FAM-CAM) and Sour Seven questionnaire that can be used by family members to detect delirium. However, neither of these tools has been used in an ICU. This study from Krewulak et al., published in CmajOPEN, shows that these tools can be used by family members to measure delirium in the ICU. The results from this study could lead to a change in policy that would involve partnering with family members to improve the diagnosis of delirium in the ICU. In turn, this would improve patient and family care and outcomes in the ICU.

This checklist was devised by the Intensive Care Society and the Faculty of Intensive care Medicine and is ready for you to download and use.

In intensive care units (ICU) and operating theatres, arterial lines are used to accurately measure a patient’s blood pressure and take numerous and repetitive blood samples. In order to prevent bacterial contamination and blood spillage from the arterial line, red arterial connectors, which are closed cap coverings, are placed on the sampling port of the arterial line. Doctors from The Queen Elizabeth Hospital NHS Foundation Trust, Kings Lynn have collaborated with Eastern Academic Health Science Network and the Patient Safety Collaborative on this patient safety solution.

This decision tree, used at the Brighton and Sussex University Hospitals NHS Trust, was developed as a ‘quick reference’ aid for nurses setting up non-invasive ventilation (NIV). It highlights key settings and signposts users to the full trust policy for more detailed explanation. It is adapted from the British Thoracic Society guidelines for acute NIV. 

Healthcare associated infections (HAI), such as ventilator-associated pneumonia (VAP), are the most common and most preventable complication of a patient’s hospital stay. Their frequency and potential adverse effects increase in critically ill patients because of impaired physiology, including a blunted immune response and multi-organ dysfunction. Traditionally, VAP rates have been measured as an indicator of quality of care. Despite recent initiatives to measure complications of mechanical ventilation and a decrease in incidence over the past few years, VAP remains an issue for critically ill adults, with mortality estimated as high as 10%. This article from Boltey et al. reviews the top five evidence-based nursing practices for reducing VAP risk in critically ill adults.