Effectiveness of nursing care in delirium associated with kidney injury in intensive care units
Keywords:
Delirium, nursing care, intensive care units, acute kidney injury, critical care nursing, (Source: DeCS).
Abstract
Delirium is one of the neurocognitive complications in critically ill patients in intensive care units (ICUs), with incidence in those who present acute kidney injury, systemic inflammation and accumulation of neurotoxins. The objective was to analyze the effectiveness of nursing interventions to prevent and reduce delirium in patients with acute kidney injury hospitalized in ICUs. The PRISMA 2020 guidelines were followed and a bibliographic search was carried out that identified 1190 records. After the application of eligibility criteria, 35 articles were included. Non-pharmacological nursing-led interventions such as cognitive reorientation, early mobilization, sleep hygiene, environmental control, family participation, and implementation of the ABCDEF package reduce the incidence, duration, and severity of delirium. It is concluded that multimodal nursing strategies are effective and safe tools to prevent and manage delirium in critically ill patients with acute kidney injury.
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References
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Vitorino, M. L., Henriques, A., Melo, G., & Henriques, H. R. (2025). The effectiveness of family participation interventions for the prevention of delirium in intensive care units: A systematic review. Intensive and Critical Care Nursing, 89(1), 234. https://doi.org/10.1016/j.iccn.2025.103976
Wang, J., Lu, Y., Chen, X., & Wu, Y. (2024). Effectiveness of nurse-led non-pharmacological interventions on outcomes of delirium in adults: A meta-analysis of randomized controlled trials. Worldviews on Evidence-Based Nursing, 21(3), 514-527. https://doi.org/10.1111/wvn.12739
Zhao, Q., Liu, S., Zhao, H., Dong, L., Zhu, X., & Liu, J. (2023). Non-pharmacological interventions to prevent and treat delirium in older people: An overview of systematic reviews. International Journal of Nursing Studies, 148(1), 458-472. Elsevier Ltd. https://doi.org/10.1016/j.ijnurstu.2023.104584
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Bennion, J., Manning, C., Mansell, S. K., Garrett, R., & Martin, D. (2024). The barriers to and facilitators of implementing early mobilisation for patients with delirium on intensive care units: A systematic review. Journal of the Intensive Care Society, 25(2), 210-222. https://doi.org/10.1177/17511437231216610
Board, R. (2022). Clinical Pearls. American Journal of Critical Care, 31(4), 265-265. https://doi.org/10.4037/ajcc2022141
Bojacá, L. C., Ortiz, J. A., & Pérez, C. A. (2023). Efecto de intervenciones musicoterapéuticas sobre prevención del delirium en UCI. Revista Avances en Salud, 7(1), 9–25. https://doi.org/10.21897/25394622.3488
Chen, T. J., Traynor, V., Wang, A. Y., Shih, C. Y., Tu, M. C., Chuang, C. H., Chiu, H. Y., & Chang, H. C. R. (2022). Comparative effectiveness of non-pharmacological interventions for preventing delirium in critically ill adults: A systematic review and network meta-analysis. International Journal of Nursing Studies, 131(1), 256-268. https://doi.org/10.1016/j.ijnurstu.2022.104239
Coolens, O., Kaltwasser, A., Melms, T., Monke, S., Nydahl, P., Pelz, S., von Haken, R., & Hasemann, W. (2025). Delirium management in 2024: A status check and evolution in clinical practice since 2016. Intensive and Critical Care Nursing, 89(1), 2345-2367. https://doi.org/10.1016/j.iccn.2025.103995
Cortés, O., Esther, L., Castaño, H., Maria, Á., Robayo, M., Rol, C. L., María, Á., & Lorena, C. (2022). Rol de enfermería frente al delirium en unidad de cuidado intensivo pediátrico: Scoping Review. Revista Cuidarte, 13(2), 126-140. https://doi.org/10.15649/CUIDARTE.2381
Dai, R. S., Wang, T. H., Chien, S. Y., & Tzeng, Y. L. (2025). Dose–response analysis of music intervention for improving delirium in intensive care unit patients: A systematic review and meta-analysis. Nursing in Critical Care, 30(5), e13230. https://doi.org/10.1111/nicc.13230
Donato, M., Carini, F. C., Meschini, M. J., Saubidet, I. L., Goldberg, A., Sarubio, M. G., Olmos, D., & Reina, R. (2021). Consensus for the management of analgesia, sedation and delirium in adults with COVID-19-associated acute respiratory distress syndrome. Revista Brasileira de Terapia Intensiva, 33(1), 48-67. https://doi.org/10.5935/0103-507X.20210005
Esteve, F., Vía, G., González, C., Cárdenas, P., Torrado, H., Granada, R. M., & Justel, R. (2026). Aplicación de un entorno multisensorial en la UCI: efecto sobre el delirium y la regulación del ritmo circadiano. Medicina Intensiva, 50(2), 346-357. https://doi.org/10.1016/J.MEDIN.2025.502347
Fernandes, F., Santos, M., Anacleto, A. M., Jerónimo, C., Ferreira, Ó., & Baixinho, C. L. (2024). Nursing intervention to prevent and manage delirium in critically ill patients: A scoping review. Healthcare, 12(11), 1134. https://doi.org/10.3390/healthcare12111134
Flores, C., Ponce, G., & Valencia, A. (2024). Escalas de valoración del delirio: un desafío en enfermería. Revista de Enfermería Neurológica, 23(2), 44–51. https://doi.org/10.24875/REN.M24000002
Gibbison, B., Johnson, A. F., Rowan, K. M., Parslow, R., Moore, A. J., Smith, S. C., ... Jones, K. L. (2026). Delirium identification, prevention and management in intensive care units in England, Wales and Northern Ireland: a survey of practice. Anaesthesia, 81(1), 41-50. https://doi.org/10.1111/anae.16728
Gómez, L. O., & Henao, Á. M. (2022). Effectiveness of nursing intervention to reduce delirium in adult critically ill - A protocol for a randomized trial. Contemporary Clinical Trials Communications, 31(2), 101042. https://doi.org/10.1016/J.CONCTC.2022.101042
Kanno, Y., Nakano, K., Kajiwara, K., Kobayashi, M., Morikawa, M., Matsuda, Y., & Kako, J. (2025). Nursing Practices for Preventing Delirium in Patients with Cancer with Prognoses of Months and Weeks: A Multi-Site Cross-Sectional Study in Japan. American Journal of Hospice and Palliative Medicine, 42(1), 1169-1180. https://doi.org/10.1177/10499091241312344
Kinalski, S. d. S., Beuter, M., Benetti, E. R. R., Leite, M. T., Venturini, L., & Brandão, M. A. G. (2023). Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos. Revista Latino-Americana de Enfermagem, 31(12), e4070. https://doi.org/10.1590/1518-8345.6707.4070
Lee, Y., Lee, J., Kim, J., & Jung, Y. (2021). Non-pharmacological nursing interventions for prevention and treatment of delirium in hospitalized adult patients: Systematic review of randomized controlled trials. International Journal of Environmental Research and Public Health, 18(3), 789-803. https://doi.org/10.3390/ijerph18168853
León López, K. D., Henao Castaño, A. M., & Alves de Araujo Püschel, V. (2022). Detección y barreras de medición de delirium en unidad de cuidado intensivo: Una revisión de alcance. Avances en Enfermería, 41(1), 567-578. https://doi.org/10.15446/AV.ENFERM.V41N1.104725
Li, J., Fan, Y., Luo, R., Wang, Y., Yin, N., Qi, W., Huang, T., Zhang, J., & Jing, J. (2025). Family involvement in preventing delirium in critically ill patients: A systematic review and meta-analysis. International Journal of Nursing Studies, 161(2), 104937. https://doi.org/10.1016/j.ijnurstu.2024.104937
Martínez, M., Cambra, S., & Fernández, M. (2024). Percepción del personal de enfermería sobre el cuidado de personas con delirium. Tesela, Liderazgo y Gestión, e15521-e15521. https://doi.org/10.58807/revtesela20247062
Martínez-Vásquez, I. E., Albornoz-Zamora, E. J., & Ramos-Argilagos, M. E. (2025). Cuidados de enfermería en terapia de reemplazo renal en pacientes críticos: revisión sistemática. Salud y Vida, 9(esp1), 591-599. https://doi.org/10.35381/s.v.v9i1.4704
Nydahl, P., Jeitziner, M. M., Vater, V., Sivarajah, S., Howroyd, F., McWilliams, D., & Osterbrink, J. (2023). Early mobilisation for prevention and treatment of delirium in critically ill patients: Systematic review and meta-analysis. Intensive and Critical Care Nursing, 74(789-804), 103334. https://doi.org/10.1016/j.iccn.2022.103334
Ocaña, M. A., Ortega, N. M., Echevarría, I., & Cervantes, M. C. (2023). Intervención de enfermería para prevenir el delirio en pacientes de la unidad de cuidados intensivos. Revista Arbitrada Interdisciplinaria de Ciencias de la Salud. Salud y Vida, 7(2), 235–242. https://doi.org/10.35381/s.v.v7i2.2922
Ospina, D. C., Avendaño, D. A. P., Jaramillo, P. J. H., & Vega, A. C. (2025). Actualización sobre la evaluación del delírium en la Unidad de Cuidados Intensivos: Una revisión de alcance. Revista Colombiana de Enfermería, 24(1), e074–e074. https://dialnet.unirioja.es/servlet/articulo?codigo=10337037
Santana, Y. G., Fernández, J. A., & Mateos, A. (2022). La clasificación de la lesión renal aguda: una herramienta para las enfermeras de críticos. Enfermería Intensiva, 33, S35-S41. https://doi.org/10.1016/j.enfi.2022.05.007
Sosnowski, K., Lin, F., Chaboyer, W., Ranse, K., Heffernan, A., & Mitchell, M. (2023). The effect of the ABCDE/ABCDEF bundle on delirium, functional outcomes, and quality of life in critically ill patients: A systematic review and meta-analysis. International Journal of Nursing Studies, 138(2), 104410. https://doi.org/10.1016/j.ijnurstu.2022.104410
Szewczak, A., Siwicka, D., Klukow, J., Czerwik-Marcinkowska, J., & Zmorzynski, S. (2025). Clinical Nursing Management of Adult Patients with Delirium in a Hospital Setting: A Systematic Review. Journal of Clinical Medicine, 14(1), 589-602. https://doi.org/10.3390/jcm14228113
Torres, C., Páez, A., Rincón, M., Carvajal, R., Herrera, M., Díaz, A. (2021). Nursing intervention to prevent delirium in critically ill adults. Revista da Escola de Enfermagem, 55(1), 1-8. https://doi.org/10.1590/S1980-220X2019035003685
Vallés, O., Rodríguez, J. J., Alonso, D., Robleda, G., López, C., Gil, D., & Acevedo, M. (2025). 10 key issues for prevention, monitoring and non-pharmacological treatment of delirium in critically ill patients. Enfermería Intensiva, 36(2), 100499. https://doi.org/10.1016/J.ENFIE.2025.100499
Vicente, J. M., Tejedor, J. A., Español, J., Pistea, V., Ibáñez, G., & Istrate, R. R. (2026). Prevención y manejo de delirium en UCI. Revisión sistemática. Revista Electrónica de PortalesMedicos.com, 21(1), 11-30. https://doi.org/10.64396/v21-0011
Villagómez, L. M., & Rivas, L. H. (2024). Efectividad de la intervención de enfermería en la prevención del delirium en pacientes críticos. Revista Cubana de Enfermería, 40, e6192. http://scielo.sld.cu/pdf/enf/v40/1561-2961-enf-40-e6192.pdf
Vitorino, M. L., Henriques, A., Melo, G., & Henriques, H. R. (2025). The effectiveness of family participation interventions for the prevention of delirium in intensive care units: A systematic review. Intensive and Critical Care Nursing, 89(1), 234. https://doi.org/10.1016/j.iccn.2025.103976
Wang, J., Lu, Y., Chen, X., & Wu, Y. (2024). Effectiveness of nurse-led non-pharmacological interventions on outcomes of delirium in adults: A meta-analysis of randomized controlled trials. Worldviews on Evidence-Based Nursing, 21(3), 514-527. https://doi.org/10.1111/wvn.12739
Zhao, Q., Liu, S., Zhao, H., Dong, L., Zhu, X., & Liu, J. (2023). Non-pharmacological interventions to prevent and treat delirium in older people: An overview of systematic reviews. International Journal of Nursing Studies, 148(1), 458-472. Elsevier Ltd. https://doi.org/10.1016/j.ijnurstu.2023.104584
Zhou, L., Xie, F., Zeng, Y., Xia, X., Wang, R., Cai, Y., Lei, Y., Xu, F., Li, X., & Chen, B. (2025). Preventive effects of early mobilisation on delirium incidence in critically ill patients: systematic review and meta-analysis. Medizinische Klinik - Intensivmedizin Und Notfallmedizin, 120(1), 15–28. https://doi.org/10.1007/s00063-024-01243-8
Published
2026-07-01
How to Cite
Hidalgo-Porras, J., Yaselga-Anrango, E., & Cevallos-Benavides, J. (2026). Effectiveness of nursing care in delirium associated with kidney injury in intensive care units. CIENCIAMATRIA, 12(23), 62-80. https://doi.org/10.35381/cm.v12i23.2208
Section
De Investigación
Copyright (c) 2026 Jasmin Elizabeth Hidalgo-Porras, Edith Alexandra Yaselga-Anrango, Jenny Alexandra Cevallos-Benavides
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