Department of Psychiatry,Weill Cornell Medical College,New York,New York.
Palliat Support Care. 2019 Feb;17(1):42-45. doi: 10.1017/S1478951518000895. Epub 2019 Jan 31.
Delirium is a frequent and severe complication of serious pediatric illness. Development of a nonpharmacologic approach to prevent pediatric delirium may improve short- and long-term outcomes in children and their families. In this brief report, we describe the development of a quality improvement project designed to methodically promote the family member's engagement, comforting, and orienting activities with their critically ill child to decrease delirium rates.
We created a developmentally specific Delirium Prevention Toolkit for families. In a feasibility pilot, March through June 2016, we offered the kit to 15 patients and their families. On discharge, families were asked to describe use of the toolkit and whether or not it was helpful for them.
Twelve of 15 patients and families used various elements of the toolkit, particularly the headphones, music, and games; no one regularly used the blank journal. All reported that it was easy and helpful to have as support for their stay in the pediatric intensive care unit.Significance of resultsThis pilot demonstrated practicality of a nonpharmacologic delirium prevention toolkit in the pediatric intensive care unit, and satisfaction from patients and families.
谵妄是严重儿科疾病的常见且严重的并发症。开发一种非药物方法来预防小儿谵妄可能会改善儿童及其家庭的短期和长期预后。在这份简短的报告中,我们描述了一个质量改进项目的开发,该项目旨在系统地促进家庭成员与重病儿童的互动、安慰和定向活动,以降低谵妄发生率。
我们为家庭创建了一个特定于发育阶段的谵妄预防工具包。在 2016 年 3 月至 6 月的可行性试点中,我们向 15 名患者及其家属提供了该工具包。出院时,我们询问了家庭对工具包的使用情况以及是否对他们有帮助。
15 名患者和家属中有 12 名使用了工具包的各种元素,尤其是耳机、音乐和游戏;没有人定期使用空白日记。所有人都表示,在儿科重症监护病房中,有这样一个支持他们的工具包非常方便和有帮助。
该试点表明,非药物性谵妄预防工具包在儿科重症监护病房中的实用性,以及患者和家属的满意度。