TABLE 2.
Care Plan Components for Patients at High Risk for Delirium
| Goal: Prioritize delirium prevention interventions focused on mobility, orientation, hydration, rest and comfort, and communication. |
| Mobility |
| Goal: The patient will be mobile. |
| • Ensure patient is out of bed for meals. If this is unsafe, then put bed in chair position as alternative. |
| • All lines, catheters, monitors, and physical restraints are removed as soon as clinically indicated. |
| Orientation |
| Goal: The patient will be oriented to person, time, or place in the environment. |
| • Ensure patient’s glasses and hearing aids are available and encourage use. |
| • Orient patient to day/night, including opening blinds at sunrise and offering orienting information and activities as part of daily care. |
| Sleep, Rest, and Comfort |
| Goal: The patient will be comfortable and rested. |
| • Coordinate/cluster care to allow periods of rest and consider obtaining order for non-interrupted sleep if clinically able. |
| • Work to relieve discomfort, including discomfort associated with constipation, distended bladder, and immobility. |
| Hydration and Nutrition |
| Goal: The patient will be hydrated and nourished. |
| • Offer something to drink with each interaction as allowed, particularly in older adults due to decreased sense of thirst. |
| • Establish/maintain normal fluid/electrolytes; monitor for signs and symptoms of dehydration. |
| Collaboration and Communication |
| Goal: The patient’s status will be effectively communicated to the care team. |
| • Communicate with care team on high-risk medications and other plans to prevent delirium. |
| • Encourage family to stay with the patient. Educate family about delirium and how to help keep patient safe. |