The Role of Nursing Assessment and Management for Patients with Hyperactive Delirium in Medical Critically Ill Patients

Abstract

Delirium is common among critically ill medical patients, particularly older adults and those receiving mechanical ventilation. It causes acute, fluctuating disturbances in consciousness, cognition, and attention and is associated with adverse outcomes. Hyperactive delirium is especially challenging because patients may become agitated, aggressive, experience hallucinations, or attempt to remove medical devices, increasing the risk of injury, unplanned device removal, and the need for physical restraints or sedatives. This academic article highlights nurses’ roles in assessing and managing hyperactive delirium through systematic, regular assessment and holistic care based on the ABCDEF bundle. Key components include effective pain management and appropriate analgesia/sedation, non-pharmacological strategies to reduce triggers, early mobility, and family engagement. Implementing a structured nursing approach may reduce practice variation and enhance patient safety, dignity, and quality of care in the medical intensive care unit.