Abstract
Objective: To assess if implementation of adjusted physiologic alarm parameters are associated with a reduction in delirium in critically ill patients.|Methods: Pre-and post-intervention design evaluated frequency of alarms and presence of ICU delirium after adjustment of six physiologic alarm parameters. The incidence of ICU delirium is described by a positive CAM-ICU score.|Setting: 11-bed cardiovascular ICU at a Midwestern, tertiary care, level I trauma center.|Main Outcome Measures: Frequency of physiologic alarms and incidence of delirium in critically ill patients.|Findings: Pre-intervention there were a total of 6,824 alarms and 489 (46%) CAM positive encounters. Post-intervention there were a total of 4,961 alarms and 369 (36%) CAM positive encounters. There was a 27% reduction in alarms and a 25% reduction in CAM-ICU positive encounters.|Conclusion: Findings of this quality improvement project implied that decreasing environmental noise, though alarm reduction could be a powerful contributor to decreasing the incidence of ICU delirium. There still remains a pressing need to investigate and develop a comprehensive approach to decrease environmental noise pollution in the ICU in order to diminish delirium. Addressing environmental noise pollution provides a highly practical and effective strategy to help reduce ICU delirium in addition to known bundled interventions.