{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:16:41Z","timestamp":1792653401684,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF 20OC0066074"],"award-info":[{"award-number":["NNF 20OC0066074"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2010pharmacologic interventions might be effective to reduce the incidence of delirium in pediatric intensive care units (PICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore expert opinions and generate informed consensus decisions regarding the content of a non\u2010pharmacologic delirium bundle to manage delirium in PICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>A two\u2010round online Delphi study was conducted from February to April 2021. PICU experts (nurses, physicians, researchers, physical therapists, play specialists, and occupational therapists) located in Europe, North America, South America, Asia, and Australia participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We developed a questionnaire based on the outcomes of a comprehensive literature search in the domains: 1) cognition support; 2) sleep support; and 3) physical activity support. Under these domains, we listed 11 strategies to promote support with 61 interventions. Participants rated the feasibility of each intervention on a 9\u2010point Likert scale (ranging from 1 strongly disagree to 9 strongly agree). A disagreement index and panel median were calculated to determine the level of agreement among experts. In the second round, participants reassessed the revised statements and ranked the interventions in each domain in order of importance for age groups: 0\u20132, 3\u20135, and 6\u201318 years of age. During the first Delphi round, 53 of 74 (72%) questionnaires were completed, and in the second round 45 of 74 (61%) were completed. Five of the highest ranked interventions across the age groups were: 1) developing a daily routine, 2) adjusting light exposure according to the time of day, 3) scheduling time for sleep, 4) providing eyeglasses and hearing aids if appropriate, 5) encouraging parental presence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on expert consensus, we developed an age\u2010specific non\u2010pharmacologic delirium bundle of interventions to manage delirium in PICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>An age\u2010specific Non\u2010Pharmacological Delirium bundle is now ready to be tested in the PICU and will hopefully reduce pediatric delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.12809","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T07:41:01Z","timestamp":1655797261000},"page":"867-876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Development of a non\u2010pharmacologic delirium management bundle in paediatric intensive care units"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6831-7376","authenticated-orcid":false,"given":"Rikke Louise","family":"Stenkjaer","sequence":"first","affiliation":[{"name":"Department of Neonatology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne Forsyth","family":"Herling","sequence":"additional","affiliation":[{"name":"The Neuroscience Centre Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9576-4390","authenticated-orcid":false,"given":"Ingrid","family":"Egerod","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Weis","sequence":"additional","affiliation":[{"name":"Department of Neonatology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Pediatric Intensive care, Erasmus MC \u2013 Sophia Children's Hospital  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sapna Ravi","family":"Kudchadkar","sequence":"additional","affiliation":[{"name":"Anesthesiology &amp; Critical Care Medicine, Pediatrics, and Physical Medicine &amp; Rehabilitation, Associate Vice Chair for Research, ACCM Johns Hopkins University School of Medicine, Charlotte Bloomberg Children's Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8809-2920","authenticated-orcid":false,"given":"Anne\u2010Sylvie","family":"Ramelet","sequence":"additional","affiliation":[{"name":"Institute of Higher Education and Research in Healthcare (IUFRS) University of Lausanne  Lausanne Switzerland"},{"name":"Department Woman\u2010Mother\u2010Child Lausanne University Hospital  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1257-3108","authenticated-orcid":false,"given":"Erwin","family":"Ista","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617728030"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002591"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000326"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002515"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200706-857OC"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.20.2561"},{"issue":"11","key":"e_1_2_9_8_1","first-page":"Cd009771","article-title":"Protocol\u2010directed sedation versus non\u2010protocol\u2010directed sedation in mechanically ventilated intensive care adults and children","volume":"11","author":"Aitken LM","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002324"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2971-3"},{"issue":"7","key":"e_1_2_9_11_1","first-page":"Cd013307","article-title":"Non\u2010pharmacological interventions for preventing delirium in hospitalised non\u2010ICU patients","volume":"7","author":"Burton JK","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_12_1","first-page":"Cd005563","article-title":"Interventions for preventing delirium in hospitalised non\u2010ICU patients","volume":"3","author":"Siddiqi N","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12594"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2017531"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002588"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.826259"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1655"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1002\/9781444392029","volume-title":"The Delphi Technique in Nursing and Health Research","author":"Keeney Sea","year":"2011"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2006.03716.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867415600891"},{"key":"e_1_2_9_23_1","unstructured":"https:\/\/www.welphi.com\/Home.html.Welphi"},{"issue":"4","key":"e_1_2_9_24_1","first-page":"373","article-title":"World Medical Association Declaration of Helsinki. 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