Title: Delirium in the ICU: Prevalence and Opportunities for Occupational Therapy 

Authors:
Veronique Munier, OTD, OTR/L
Dana M. Howell, PhD, OTD, OTR/L, FAOTA
Renee Causey-Upton, PhD, OTD, OTR/L, CLA, FAOTA

JACOT Volume 5, Issue 2

Abstract

Background
Delirium affects 30% of patients in the intensive care unit and has been associated with increased length of stay and mortality. Occupational therapy shows promise to mitigate delirium and improve outcomes in the intensive care unit.
Methods
This retrospective chart review sought to estimate the prevalence of delirium, calculate the rate of assessment, and describe occupational therapy services in a medical intensive care unit to offer insight into opportunities for occupational therapy intervention addressing cognitive dysfunction (or delirium). The design was a retrospective chart review. Data was collected from the charts of 100 patients in one intensive care unit in the fall of 2021.
Results
The prevalence for delirium was 20%, which could be influenced by insufficient monitoring. During the study, 93 patients were monitored for delirium by nursing, and 6 were monitored by occupational therapists. Occupational therapy services were performed in 47 of the 100 cases reviewed, with mobilization being the most common intervention (44 cases), compared to activities of daily living (34 cases) and cognitive function (14 cases). Occupational therapy chart documentation included statements regarding delirium screening or intervention in 8 cases. The median number of days between admission and the first occupational therapy intervention was 4 with a wide variation (1 to 26 days).
Conclusion
The study highlights opportunities for occupational therapists to monitor and mitigate delirium in the intensive care unit, by screening for delirium using a variety of tools, documenting delirium intervention, integrating cognitive retraining, promoting early intervention, and performing early mobility.