赤松 由希絵

Introduction This study aimed to evaluate the impact of the no-visitation policy and the presence or absence of remote visitation during the policy period on delirium in intensive care unit (ICU) patients requiring mechanical ventilation and to obtain implications for critical care nursing practice. This research is important for informing ICU family visitation policies, as delirium is associated with increased mortality and prolonged ICU stay, and understanding the impact of family presence on delirium prevention has significant clinical implications. Methods This single-center retrospective observational study included patients who received mechanical ventilation for at least 48 hours between February 2019 and October 2022. Patients were divided into two groups based on before and after the implementation of the no-visitation policy due to the COVID-19 pandemic, and the incidence and duration of delirium were compared. Delirium was assessed using the Intensive Care Delirium Screening Checklist (ICDSC), and logistic regression analysis was used to analyze the impact of the no-visitation policy on delirium occurrence. Results The study included 359 patients (pre-policy group: 183 patients, post-policy group: 176 patients). Patient demographics included a median age of 69 years (interquartile range: 56-78), Acute Physiology and Chronic Health Disease Classification System II (APACHE II) score of 21 (range: 16-27), and mechanical ventilation duration of eight days (range: 5-17). The incidence of delirium was 72.7% (133/183) in the pre-policy group and 65.9% (116/176) in the no-visitation policy group (p=0.164). The duration of delirium was four (range: two to seven) days in both groups (p=0.593). There was also no significant difference in delirium incidence based on whether remote visitation was provided in the no-visitation policy period (p=0.81). Conclusions The no-visitation policy was not significantly associated with the incidence or duration of delirium in ICU patients requiring long-term mechanical ventilation. We are suggesting that comprehensive non-pharmacological interventions, rather than family visitation alone, may be essential for delirium prevention in high-risk ICU populations.