{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T11:54:04Z","timestamp":1777118044140,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["80-84300-98-71006"],"award-info":[{"award-number":["80-84300-98-71006"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Delirium is a pathobiological brain process that is frequently observed in Intensive Care Unit (ICU) patients, and is associated with longer hospitalization as well as long-term cognitive impairment. In neurological ICU patients, delirium may be more treatment-resistant due to the initial brain injury. This study examined the effects of a multicomponent non-pharmacological nursing intervention program on delirium in neurological ICU patients. Methods: A single-center interrupted time series trial was conducted in adult neurological ICU patients at high risk for developing delirium who were non-delirious at admission. A multicomponent nursing intervention program focusing on modifiable risk factors for delirium, including the optimalization of vision, hearing, orientation and cognition, sleep and mobilization, was implemented as the standard of care, and its effects were studied. The primary outcome was the number of delirium-free and coma-free days alive at 28 days after ICU admission. The secondary outcomes included delirium incidence and duration, ICU and hospital length-of-stay and duration of mechanical ventilation. Results: Of 289 eligible patients admitted to the ICU, 130 patients were included, with a mean age of 68 \u00b1 11 years, a mean APACHE-IV score of 79 \u00b1 25 and a median predicted delirium risk (E-PRE-DELIRIC) score of 42 [IQR 38\u201350]). Of these, 73 were included in the intervention period and 57 in the control period. The median delirium- and coma-free days alive were 15 days [IQR 0\u201326] in the intervention group and 10 days [IQR 0\u201324] in the control group (level change \u22120.48 days, 95% confidence interval (95%CI) \u22127 to 6 days, p = 0.87; slope change \u22120.95 days, 95%CI \u22122.41 to 0.52 days, p = 0.18). Conclusions: In neurological ICU patients, our multicomponent non-pharmacological nursing intervention program did not change the number of delirium-free and coma-free days alive after 28 days.<\/jats:p>","DOI":"10.3390\/jcm12185820","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T10:09:50Z","timestamp":1694081390000},"page":"5820","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Impact of Non-Pharmacological Interventions on Delirium in Neurological Intensive Care Unit Patients: A Single-Center Interrupted Time Series Trial"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8013-1243","authenticated-orcid":false,"given":"Paul J. T.","family":"Rood","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Research Department of Emergency and Critical Care, School of Health Studies, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-2780","authenticated-orcid":false,"given":"Dharmanand","family":"Ramnarain","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Elisabeth Tweesteden Hospital, Hilvarenbeekseweg, P.O. Box 90151, 5000 LE Tilburg, The Netherlands"},{"name":"Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie W.","family":"Oldenbeuving","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Elisabeth Tweesteden Hospital, Hilvarenbeekseweg, P.O. Box 90151, 5000 LE Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-5434","authenticated-orcid":false,"given":"Brenda L.","family":"den Oudsten","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-7692","authenticated-orcid":false,"given":"Sjaak","family":"Pouwels","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Elisabeth Tweesteden Hospital, Hilvarenbeekseweg, P.O. Box 90151, 5000 LE Tilburg, The Netherlands"},{"name":"Department of General and Abdominal Surgery, Helios Klinikum, Lutherplatz 40, 47805 Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8259-2497","authenticated-orcid":false,"given":"Lex M.","family":"van Loon","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"College of Health and Medicine, Australian National University, 131 Garran Rd, Acton, Canberra, ACT 2601, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-7451","authenticated-orcid":false,"given":"Steven","family":"Teerenstra","sequence":"additional","affiliation":[{"name":"Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Pickkers","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"},{"name":"Radboud Center for Infectious Diseases, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands"},{"name":"Admiraal de Ruyter Hospital (Adrz), P.O. Box 15, 4462 RA Goes, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4233-2903","authenticated-orcid":false,"given":"Mark","family":"van den Boogaard","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1007\/s00134-019-05907-4","article-title":"Updated nomenclature of delirium and acute encephalopathy: Statement of ten Societies","volume":"46","author":"Slooter","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102816","DOI":"10.1016\/j.iccn.2020.102816","article-title":"Delirium prevalence and prevention in patients with acute brain injury: A prospective before-and-after intervention study","volume":"59","author":"Larsen","year":"2020","journal-title":"Intensive Crit. 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