Experience Summary

These patient scenarios are all based on real experiences. The care you encounter may sometimes follow best practice and sometimes fall short, by design, to prompt reflection and discussion.

Clinical Context

Delirium is defined as ‘a disturbance of consciousness characterised by an acute onset and fluctuating course of impaired cognitive functioning so that a patient's ability to receive, process, store, and recall information is strikingly impaired’ (Ely et al. 2016). Incidence can be up to 74% in ventilated critically ill patients (Intensive Care Society, 2025), with variation being linked to predisposing and precipitating factors. Delirium is a predictor of increased mortality, ventilator days, length of stay, cost, rates of re-intubation, rates of long-term cognitive impairment and rates of discharge to a long-term care facility. It is associated with feelings of stress, fear, and anxiety.

Clinical guidelines recommend education on understanding delirium, screening tools and multicomponent non-pharmacological interventions, with practical teaching methodologies being known to offer motivation for learning. These videos are designed to reflect the patient perspective and are informed by real-life accounts. They have been developed as teaching resources to encourage discussion and critical reflection. While some aspects of care align with current recommendations, others have been intentionally varied for educational purposes. The Guidelines for Delirium in the Critically Ill (ICS, 2025) should always be consulted.

External Resources

• Ely, E., Inouye, S., Bernard, G., Gordon, S. et al. (2001) Delirium in mechanically ventilated patients; Validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM- ICU). JAMA. 286 (21), pp. 2703- 2710. Available at: Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) - PubMed (nih.gov) pp. 2703. 
• Intensive Care Society. (2025). Guidance for: Delirium in the critically ill patient. Available at: https://ics.ac.uk/resource/guidance-for-delirium-in-the-critically-ill-patient-pdf.html