All posts by Vatina

ICU Delirium

ICU Delirium: Nursing and Medical Staff Knowledge of Current Practices and Perceived Barriers
Delirium is a common problem in the ICU. It’s divided into three subtypes (hyperactive, hypoactive, and mixed delirium). It’s been known that delirium in the ICU is associated with prolonged hospital and ICU stays. It is also associated with an increased six month mortality rate. The Intensive Care Society recommends screening for delirium on a daily basis using a validated screening tool such as the CAM-ICU. Two thirds of cases could be missed if a validated screening tool isn’t used. This article is suggesting that there is a lack of knowledge on ICU delirium, the screening tools used to assess it and also that it is not screened for on a regular basis, partly due to perceived barriers to screening. A sample of 149 nurses and medical staff from three different hospitals were surveyed.
The results show that 44% of the respondents never received any training or education on ICU delirium and that 37% used a delirium screening tool. 51% said they did not use a screening tool. The rest checked off “did not know”. The majority of respondents said they knew about the CAM-ICU screening tool but did not use it on a regular basis. The second most recognized screening tool was the ICDSC (Intensive Care Delirium Screening Checklist). 52% said they screened for ICU delirium on a daily basis and 14% said they screened for it on a weekly basis and another 14% said they screened on a monthly basis. The ones that did not use a screening tool said they just observed for hallucinations, agitation, and confused patients.
Some of the respondents said they did not screen for delirium due to perceived barriers such as it was time consuming to complete, that it would take up valuable nursing and medical staff time. Some were also unconfident at detecting delirium.
This article also revealed that the nurses and medical staff had some knowledge of ICU delirium but the education they received was during school and not at bedside. They also found that the staff had a medium level of knowledge about the risk factors and complications of ICU delirium.
I agree with the article in that most of the staff at many hospitals lack education on ICU delirium. This article brings to light how serious ICU delirium is and how much training and education needs to be done. The CAM-ICU takes about 2-5 minutes and needs to be done at least on a daily basis, not weekly or monthly. The medical staff who do not use a structured validated tool to assess delirium confirms that many of the ICU delirium cases are missed or are identified as hyperactive (least common) when it should be identified as hypoactive or mixed.


Elliott, Sara.  ICU delirium: A survey into nursing and medical staff knowledge of current practices and perceived barriers towards ICU delirium in the intensive care unit, Intensive and Critical Care Nursing (2014) 30, 333-338.

Digital Technology & Healthcare

I think digital technology in the field of healthcare is great. It has allowed researches to gain a lot of insight on health issues such as mental health, academic performance, and behavioral trends. Computers process the information in a clear, organized way and it has saved a tremendous amount of time on the researchers’ part.
Abnormal heart rhythms are another area where technology has come a long way in, specifically atrial fibrillation. Many people have died due to clots resulting from AF. Now we have pacemakers and defibrillators that continuously report data to help diagnose and understand this condition better. According to results from a Canadian randomized clinical trial, patients who wore ambulatory EKG monitors for 30 days had better outcomes because AF was diagnosed five times more frequently in those patients vs. those who underwent conventional 24hr testing.
Technology has improved and saved many lives. It allows us to share information more easily in a matter of seconds. If I’m missing an H&P or if I need orders, I can call the doctor and they can just log on from where they’re at and I’ll get it in a couple minutes. Technology is also wonderful when it comes to patient education. More and more doctors’ offices and hospitals use tablets now in addition to one on one teaching to show patients where they can obtain more info on disease process and other support websites. Technology is here to stay so nurses need to jump on board.


Hi my name is Vatina Thongtha. I graduated from Ventura College in 2013. Since then I have been working in the Main OR at Community Memorial Hospital. I love being an OR nurse and this is where I see myself for many more years. I am married and have 2 boys. I am currently expecting my third child, a girl finally! In my spare time, I like to watch movies and go shopping!