Application effect of routine nursing combined with early activities to prevent the delirium in patients with mechanical ventilation in ICU

Objective To explore the effect of routine nursing combined with early activities in the prevention of delirium in patients with mechanical ventilation in intensive care unit (ICU). Methods We collected 180 patients receiving mechanical ventilation in ICU from July 2014 to June 2016 in the Fifth Affiliated Hospital of Wenzhou Medical University (Lishui Central Hospital). The patients were randomly divided into intervention group and control group. The control group was given conventional care, and the intervention group was given early movement on the basis of routine care. The clinical data of the two groups were collected. Results There was no significant difference in the incidence of delirium into the ICU < 8 h between the intervention group and the control group (P > 0. 05). The incidence of delirium into the ICU 8-48 h, 48 h-out ICU of the intervention group (8. 9%, 2. 2%) were lower than those in the control group (25. 6%, 14. 4%), P < 0. 05. The total delirium rate of the intervention group (20. 0%) was lower than that in the control group (50. 0%), P < 0. 05. There was no significant difference in the proportion of delirium reduced activity type, increased activity type and mixed type between the intervention group and the control group (P > 0. 05). In 63 patients with delirium, there were 4 cases of reduced activity, 37 cases of increased activity, and 22 cases of mixed type. There was no significant difference in the delirium occurring time between the intervention group[(2. 32 ±1. 46) days] and the control group[(2. 41 ±1. 54) days], P > 0. 05. The duration of delirium in the intervention group[(1. 87 ±1. 25) days]was shorter than that in the control group[(3. 06 ±1. 69) days], P < 0. 05. The duration of ventilation, treatment cost, hospital stay[(91. 23 ±43. 26) h, (1. 58 ±0. 87) ten thousand yuan, (6. 32 ±4. 31) days]in the intervention group were lower than those in the control group[(122. 25 ±51. 27) h, (2. 12 ±1. 24) ten thousand yuan, (8. 67 ±4. 65) days], P < 0. 05. Conclusion The combination of routine care and early intervention can reduce the incidence of delirium in patients with ICU mechanical ventilation, reduce delirium duration and ICU stay, reduce treatment costs, and have no significant effect on delirium classification and ventilation time.