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Intensive Crit Care Nurs. 2018 Oct;48:52-60. doi: 10.1016/j.iccn.2018.01.008.

Gaps in pain, agitation and delirium management in intensive care: Outputs from a nurse workshop.

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Executive Member of the German DELIR Network, Friedrich-Ebert-Straße 60, 53177 Bonn, Germany. Electronic address:
Hospital Puerta Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain; Universidad Autónoma de Madrid, C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain. Electronic address:
X-92, C Floor, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. Electronic address:
Sahlgrenska University Hospital East, Blå stråket 5, 413 45 Göteborg, Sweden. Electronic address:
Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy. Electronic address:
UniversitätsSpital Zürich, Medizinbereich Anästhesiologie, Intensivmedizin, Operations Management, Gloriastrasse 19, 8091 Zurich, Switzerland. Electronic address:


Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation. Where do the gaps exist in pain, agitation and delirium management, what are the barriers to guideline implementation and how can these problems be addressed to ensure patients receive optimised care? As an international professional consensus exercise, a panel of seven European intensive care nurses convened to discuss how to address these questions and establish how the provision of pain, agitation and delirium management can be improved in the intensive care unit.


Delirium; ICU; Multidisciplinary; PAD guidelines; Sedation

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