Table 1.

Risk factors for delirium and standardized protocols*

Risk factor	Standardized protocol
Cognitive impairment	Orientation protocol: board with names of care team members and day’s schedule; communication to re-orient to surroundings Therapeutic activities protocol: cognitively stimulating activities three times daily (e.g.-discussion of current events, or word games)
Sleep deprivation	Nonpharmacologic sleep protocol: at bedtime, warm milk or herbal tea, relaxation tapes or music, and back massage Sleep-enhancement protocol: unit wise noise reduction strategies, and adjust schedules to allow sleep (e.g.- medications and procedures)
immobility	Early-mobilization protocol: ambulation or active range of motion exercises three times daily, minimal use of immobilizing equipment
Visual impairment	Vision protocol: visual aids (glasses or magnifying lens)and adaptive equipment (e.g.-large print books) with daily reinforcement of their use
Hearing impairment	Hearing protocol: portable amplifying devices, earwax removal, and special communication techniques with daily reinforcement of these adaptations
dehydration	Dehydration protocol: early recognition of dehydration and volume repletion (encourage oral intake of fluids)

Adapted from ¹⁶.