A Multimodal Approach to Delirium: From the ABCDEF Bundle to Artificial Intelligence and the Indispensable Role of Nursing

Delirium, characterized by an acute and fluctuating disturbance in attention and awareness, constitutes a common and severe complication among critically ill individuals. This condition is associated with extended hospital stays, enduring cognitive deficits, elevated healthcare expenditures, and increased rates of mortality. Although evidence-based protocols—including routine assessment via validated instruments such as the CAM-ICU and the adoption of multicomponent strategies like the ABCDEF bundle—demonstrate efficacy, a substantial theory-practice gap endures worldwide. This discrepancy is fueled by systemic obstacles such as inadequate staffing, insufficient knowledge, and inconsistent institutional prioritization. In response to these impediments, modern methodologies advocate for multimodal initiatives that target modifiable risk factors, including disturbances to the sleep-wake cycle, the proactive engagement of family members, and the incorporation of artificial intelligence to facilitate early detection and provide clinical decision support. The pivotal contribution of nursing personnel in executing and coordinating these interventions is irreplaceable, necessitating ongoing education and robust interprofessional collaboration. This manuscript consolidates contemporary evidence pertaining to core care bundles, technological innovations, environmental adjustments, family engagement, and nursing practice. It aims to offer a holistic framework for the prevention, identification, and management of delirium, with the final objective of enhancing patient-centered outcomes within high-acuity clinical environments.

کلیدواژه ها:

Delirium ، Nursing Care ، ABCDEF Bundle ، Artificial Intelligence ، Sleep Disruption