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Evaluating Intensive Nursing Interventions for Managing Delirium in Intensive Care UnitsNew research ranks nursing interventions for patients with delirium

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Key Takeaway
Auricular points acupressure and music therapy rank highest in relative efficacy for improving delirium outcomes.

This network meta-analysis evaluates the efficacy of several intensive nursing interventions for patients experiencing delirium in the intensive care unit. The interventions analyzed include auricular points acupressure, music therapy, cognitive function exercises, increased visiting hours, and targeted nursing compared against standard nursing care.

While no single intervention demonstrated statistically significant superiority over regular nursing, the study utilized surface under the cumulative ranking area to determine relative rankings. Auricular points acupressure ranked first for both the overall cure rate and the improvement of APACHE II scores. Music therapy ranked first in improving ICDSC scores.

Increasing visiting hours also showed potential for clinical benefit. However, clinicians should note that these rankings reflect relative positions rather than absolute clinical superiority. These findings suggest that while standard care is the baseline, specific non-pharmacological interventions may offer distinct advantages in managing delirium symptoms and improving patient outcomes.

How this fits prior evidence

This finding extends prior evidence regarding sensory stimulation to reduce delirium incidence and duration in ICU patients. While previous data supported sensory stimulation as a method to improve consciousness, this network meta-analysis specifically ranks auricular points acupressure and music therapy as top-ranked interventions in cumulative ranking areas for ICU delirium. However, it does not confirm statistical superiority over regular nursing.

When a patient in an intensive care unit (ICU) experiences delirium, they become confused and lose touch with reality. It is a frightening state for both the patient and their family. Doctors are looking for the best ways to help these patients recover and improve their scores on health and cognitive assessments.

Researchers looked at several nursing interventions, including music therapy, acup_pressure on ear points, and increasing visiting hours. While several methods ranked highly in the analysis, it is important to note that none of these methods were proven to be statistically better than standard nursing care. This means the results show a relative ranking rather than a clear winner in terms of absolute effectiveness.

Auricular points acupressure ranked first for improving cure rates and lowering severity scores. Music therapy ranked first for improving cognitive scores. While these results offer a roadmap for what might work best, the evidence is still early. Because the results were not statistically significant, these methods should be discussed with a medical team to see how they fit into a specific care plan.

What this means for you:
Several nursing methods like music and acupressure rank well for delirium, but none are proven superior to standard care.

Common questions

What are the different nursing interventions for delirium?

Several methods were looked at, including music therapy, auricular points acupressure, cognitive function exercise, regular nursing, increasing visiting hours, and targeted nursing. These are used to help patients in intensive care units who are experiencing delirium.

Is music therapy effective for delirium?

Music therapy ranked first in the ranking for improving cognitive function scores. However, the study did not find a statistically significant difference when comparing music therapy to regular nursing care.

What is auricular points acupressure?

Auricular points acupressure is a technique that ranked first in the ranking for increasing cure rates and decreasing severity scores. Like other methods, it was not found to be statistically superior to regular nursing.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Delirium prevalence in the intensive care unit (ICU) is high. Intensive nursing interventions have been performed to reduce delirium in ICU patients. There is now a wide variety of intensive nursing interventions available for treating delirium. However, the optimal intervention remains unknown. This systematic review and network meta-analysis (NMA) aimed to compare the efficacy of intensive nursing interventions in patients with delirium. METHODS: We included randomized controlled trials of different intensive nursing interventions for delirium in the ICU. A Bayesian NMA was conducted to evaluate the efficacy of various types of intensive nursing interventions. The outcomes assessed were the cure rate, intensive care delirium screening checklist (ICDSC) scores, and acute physiologic assessment and chronic health evaluation II (APACHE II) scores for different treatments. RESULTS: This meta-analysis included 21 studies. We analyzed a total of 5 different intensive nursing interventions: auricular points acupressure, music therapy, cognitive function exercise, regular nursing, increasing visiting hours, and targeted nursing. When compared with regular nursing, the other 5 intensive nursing interventions showed no significant difference in cure rate, ICDSC, and APACHE II scores (P > .05). Auricular points acupressure had the highest surface under the cumulative ranking area value for cure rate and APACHE II, indicating it ranked first in these outcomes. Music therapy demonstrated the most favorable effect on reducing ICDSC, with music therapy ranking first in this regard. CONCLUSION: This NMA suggests that auricular points acupressure might be the optimal intervention for increasing the cure rate and decreasing ICDSC and APACHE II scores in ICU patients with delirium. However, the surface under the cumulative ranking area values reflect relative ranking rather than absolute efficacy, and no intervention demonstrated statistically significant superiority over regular nursing. Additionally, increasing visiting hours appears to hold promise as an effective intervention for reducing delirium in the ICU. Further research and larger studies are warranted to confirm these findings and to explore the long-term benefits of these intensive nursing interventions in delirium management.
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