Unreal experiences: clinical advice for the care of patients with post-operative confusion

Abstract

Post-operative confusion is a relatively common and well-known condition in patients who are treated in intensive care units. As many as 72% of all patients who are treated in intensive care exhibit signs of confusion. It is a psychosis-like condition in which patients can have difficulty in co-ordinating thought and speech, in orientating themselves in time and space, and in receiving and processing information.Some patients can have occasional unreal experiences. Suspicion, fear, anxiety and aggressive behaviour can develop. Certain patients become euphoric whereas others exhibit passive behaviour.Signs of post-operative confusion can develop two or three days after the patient's arrival in the intensive care unit and can last for several weeks. The nurse is often the first person who notices the patient's confusion. However, the nurse, together with other members of the healthcare staff may be indaequately experienced to identify and treat the various stages of confusion.This article describes a project to produce clinical advice for intensive care nurses regarding the care of patients with post-operative confusion, based on scientific literature and practical experience.