A nurse led intervention to prevent delirium among adults admitted to Intensive Care,

INTERVENTION: The intervention will incorporate a nurse led delirium prevention protocol, targeting risk factors for delirium: (1) visual and hearing impairment ‐ nurses will ensure that all patient who usually need glasses, or hearing aids will use them during their ICU stay; (2) to prevent and treat sensory deprivation, cognitive impairment, and loss of orientation ‐ all patients will be re‐orientated to place, person, and time at the start of nursing shift and during the daily medical round; (3) Sleep deprivation will be minimised, and avoided where possible by ensuring minimal nursing care during the night shift (between 10pm and 6am in the morning), and overnight use of lights will be minimised, and noise kept to a level to facilitate/optimise sleeping; and, (4) lack of mobility ‐ staff will attempt to improve functional mobility while in the intensive care, and also stimulate cognition, this will be undertaken in collaboration with the physiotherapy and occupational therapy teams to ensure patient (when able), will sit out of bed and mobilise within the ICU. Nursing staff will use checklists to direct interventions, and regular delirium prevention rounds (one per shift) will be undertaken to ensure application of interventions to reduce the risk of delirium. CONDITION: Delirium PRIMARY OUTCOME: Incidence of delirium will assessed using the ICU‐CAM scale, which categorising patients as CAM +ve, CAM ‐ve for delirium, or un‐assessable due to coma. SECONDARY OUTCOME: Along with the identification of the primary outcomes of the incidence of delirium during first 28‐days in the intensive car, each patient's daily CAM result will determine a delirium or delirium free day. INCLUSION CRITERIA: All adults aged 18 years or more admitted to the intensive care during the study period.