The 2023 World delirium awareness and quality Survey: A Canadian substudy.

OBJECTIVE

This study aimed to evaluate the proportion of screened patients with delirium and the strategies used for its management in Canadian hospitals caring for critically ill children or adults.

METHODS

This is a secondary analysis of a cross-sectional study completed on World Delirium Awareness Day (March 15, 2023). Respondents completed a 35-question survey on the proportion of screened patients with delirium (at 8:00 am and 8:00 pm), treatment, and management strategies employed.

RESULTS

A total of 27 ICUs (22 adult and 5 pediatric) participated. Among adult ICU patients assessed for delirium, 18 % (n = 34/194) had delirium at 8:00 am and 18 % (32/181) had delirium at 8:00 pm. In pediatric ICUs, the proportion of screened patients with delirium was higher, with 50 % (n = 8/16) at 8:00 am and 44 % (n = 7/16) at 8:00 pm. Delirium management strategies varied: with non-pharmacological approaches such as multi-professional rounds (100 %), pain management (96 %), and mobilization (85 %) being most common. The most reported written delirium management protocols included spontaneous breathing trials in adult ICUs and physical restraint and sedation management in PICUs. Few ICUs reported written protocols for family engagement and empowerment.

CONCLUSIONS

Delirium remains a prevalent issue in Canadian ICUs, with variability in assessment and management strategies. Gaps in family engagement and pediatric-specific protocols persist. Addressing barriers like staff shortages and lack of training is critical to improving care.

IMPLICATIONS FOR CLINICAL PRACTICE: Improving delirium management requires standardized protocols, especially in PICUs, and better integration of family engagement in care. Addressing workforce challenges (e.g., staff shortages and educating new staff on delirium) will be crucial for enhancing delirium prevention and treatment in Canadian ICUs. Further research should focus on pediatric-specific interventions and pharmacological management.