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Risk factors for delirium and standardized protocols*

Risk factorStandardized protocol
Cognitive impairmentOrientation protocol: board with names of care team members and day’s schedule; communication to re-orient to surroundings
Therapeutic activities protocol: cognitively stimulating activities three times daily (e.g.-discussion of current events, or word games)
Sleep deprivationNonpharmacologic sleep protocol: at bedtime, warm milk or herbal tea, relaxation tapes or music, and back massage
Sleep-enhancement protocol: unit wise noise reduction strategies, and adjust schedules to allow sleep (e.g.- medications and procedures)
immobilityEarly-mobilization protocol: ambulation or active range of motion exercises three times daily, minimal use of immobilizing equipment
Visual impairmentVision protocol: visual aids (glasses or magnifying lens)and adaptive equipment (e.g.-large print books) with daily reinforcement of their use
Hearing impairmentHearing protocol: portable amplifying devices, earwax removal, and special communication techniques with daily reinforcement of these adaptations
dehydrationDehydration protocol: early recognition of dehydration and volume repletion (encourage oral intake of fluids)