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Implementation of the Pain, Agitation, and Delirium Clinical Practice Guidelines and Promoting Patient Mobility to Prevent Post-Intensive Care Syndrome

Davidson, Judy E. DNP, RN, FCCM1; Harvey, Maurene A. RN, MPH, MCCM2; Bemis-Dougherty, Anita PT, DPT, MAS3; Smith, James M. PT, DPT4; Hopkins, Ramona O. PhD5,6

doi: 10.1097/CCM.0b013e3182a24105
Creating and Implementing the 2013 ICU Pain, Agitation, and Delirium Guidelines for Adult Icu Patients

Surviving critical illness is associated with persistent and severe physical, cognitive, and psychological morbidities. The Society of Critical Care Medicine has developed pain, agitation, and delirium guidelines and promoted mobility to improve care of critically ill patients. A task force has developed tools to facilitate and rapidly implement the translation of guideline care recommendations into practice. The Society of Critical Care Medicine has also assembled a task force to assess the long-term consequences of critical illness. This article will explore relationships between the pain, agitation, and delirium guidelines, mobility recommendations, and post-intensive care syndrome initiative. Implementation of the pain, agitation, and delirium guidelines taking into account current data regarding post-intensive care syndrome outcomes and potential interventions are an important first step toward improving outcomes for patients and their families. Research is needed to reduce the impact of long-term negative consequences of critical illness and to fully understand the best within- and post-ICU interventions, along with the optimal timing and dose of such interventions to produce the best long-term outcomes.

1Evidence-based Practice and Research Liaison, UCSD Medical Center, San Diego, CA.

2Critical Care Educator and Consultant, Glenbrook, NV.

3Clinical Practice, American Physical Therapy Association, Alexandria, VA.

4Department of Physical Therapy, Utica College, Utica, NY.

5Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT.

6Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT.

Dr. Davidson has received speaking honoraria and travel support from Hospira and the France Foundation. Ms. Harvey has received travel support from the Society of Critical Care Medicine. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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© 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins