Clinical Nursing Management of Adult Patients with Delirium in a Hospital Setting—A Systematic Review

Abstract

Background/Objectives: Delirium is a common and serious neurocognitive disorder among hospitalised adults, which is associated with prolonged hospital stays, increased treatment costs, and increased mortality. Nurses, as healthcare professionals in constant contact with patients, play crucial roles in the early recognition, prevention, and management of delirium. This systematic review aimed to synthesise the evidence on nursing roles and interventions in the recognition, prevention, and treatment of delirium in hospitalised adult patients. Methods: A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and CINAHL/EBSCO for studies published between January 2015 and August 2025. The protocol was registered in PROSPERO. Results: Out of the 3791 records identified, 39 met the inclusion criteria. Studies included randomised controlled trials, systematic reviews, and cross-sectional studies conducted in various hospital settings. Key nursing roles included early detection of risk factors, routine use of tools (e.g., CAM, CAM-ICU, 4AT), and implementation of multicomponent nonpharmacological prevention programs for patients with delirium. The evidence regarding the effectiveness of nurse-led interventions has been mixed: several studies reported reductions in delirium incidence and duration with early mobilisation, sleep promotion, cognitive stimulation, pain control and family involvement, whereas others reported no statistically significant effects. Conclusions: Routine screening, targeted nonpharmacological interventions, and interdisciplinary collaboration are essential for improving delirium-related outcomes. However, the findings should be interpreted with caution due to differences in the study design, variability in nursing practice across countries, and language restrictions that may have limited the scope of the review. Further high-quality studies are needed to clarify the impact of specific nursing-led strategies on delirium outcomes.