The role of nursing in the prevention and management of delirium in critically ill patients

Abstract

Delirium is a frequent acute neurological condition in critically ill patients, characterized by altered consciousness and cognition, fluctuations in mental status, and inattention, which can compromise functional recovery, prolong hospitalization, and increase mortality. In this context, the nursing team plays a central role in the early detection, prevention, and management of the syndrome. The objective of this study was to analyze the role of nursing in the prevention and management of delirium in critically ill patients. To this end, an integrative literature review was conducted, with a systematic search of articles in the Google Scholar, SciELO, and PubMed databases, between 2023 and 2025. The results showed that nursing plays a strategic and continuous role in the prevention and management of delirium, standing out in neurological monitoring, application of validated scales (CAM-ICU, ICDSC, Nu-DESC, RASS), and implementation of non-pharmacological interventions, such as environmental control, early mobilization, cognitive stimulation, maintenance of the sleep-wake cycle, temporal and spatial reorientation, pain management, and encouragement of family presence. The nurse also coordinates interdisciplinary care, ensuring communication between teams and the continuity of preventive practices. Qualified nursing performance directly impacts patient safety, reduces length of stay, and prevents long-term cognitive complications. Studies reinforce the need for continuous training, consolidated institutional protocols, structural improvements, and strengthened teamwork to optimize care. It is concluded that nursing is central to addressing delirium in ICUs, assuming responsibilities from early detection to the execution of complex interventions.