Research outlines new family-led intervention to prevent delirium in critically ill patients

Gideon Johnson, a Senior Teaching Fellow in the Faculty of Nursing, Midwifery and Palliative Care, has been working on a family-led intervention to prevent critical illness brain dysfunction, also known as delirium.

The intervention, called Family Member’s Voice Reorientation Intervention (FAMVR) uses familiar voices to provide ongoing orientation to critically ill patients in order to prevent or manage delirium.

Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimize delirium in intensive care. Up to this point, people with lived experience of intensive care have seldom been involved in codesigning delirium prevention and management interventions, despite the identified benefit of their involvement in delirium care.

The development of FAMVR was done with collaboration from people with lived experience of the ICU, as patients, family members, nursing and medical staff.

Through consultations and focus groups, researchers created drafts of scripted messages that family members could record for patients in the ICU, that would be played to those experiencing delirium to orient patients and reduce their experience of delirium.

Two research papers have been published from the first phase of Gideon’s two-phase study, entitled “The Development, Implementation and Evaluation of a Novel Intervention for Delirium Prevention and Management in Adult Intensive Care Unit: A Mixed Methods Study.” This study formed a part of his Ph.D.

One paper, published in the International Journal of Nursing Studies focuses on the study’s unique methodology. The other study, published in Australian Critical Care presents the findings.

“This study addresses a critical gap in intensive care practice by highlighting the necessity of co-designed interventions tailored to the needs of both patients and their families. The use of the Double Diamond model ensured a structured and iterative process, allowing us to create a more human-centered approach to delirium prevention and management.

“By engaging end-users from the outset, we’ve developed a digital intervention that not only enhances care but also empowers families as active participants in the healing process. I hope this research paves the way for more collaborative, co-designed solutions in critical care settings, improving outcomes for critically ill patients,” says Johnson.

Phase two of the study has already been completed, with a paper under review and a publication expected soon. These Phase one findings are now contributing to a broader initiative: a Critical Illness Brain Dysfunction Survivorship Program that Johnson is establishing in the U.K., modeled after the CIBS program in the U.S.

This program will further the impact of the intervention, addressing long-term cognitive issues following critical illness.