Innovative Organizational Strategies in Managing Icu Delirium: Mitigating Nursing Burnout and Improving Critical Care Quality

Background and Aim: Delirium in the Intensive Care Unit (ICU) is a complex dysfunction that poses not only a clinical threat but also a massive organizational challenge, affecting the quality of care and staff well-being. This review aims to systematize knowledge on innovative strategies for delirium management, with a specific focus on mitigating nursing burnout and implementing the integrated ABCDEF bundle as an organizational protocol in light of the PADIS (2025) and ESAIC (2024) guidelines. Methodology: A narrative literature review (2015–2026) was conducted using PubMed/MEDLINE, Scopus, and the Cochrane Library, focusing on management innovations, burnout research, and non-pharmacological interventions. Results: Traditional, pharmacologically driven methods fail to yield expected results, and the growing workload drives a severe staffing crisis. The application of the integrated ABCDEF bundle (early mobilization, analgosedation optimization) as a structural innovation in daily workflow reduces delirium incidence by 50%. The routine use of antipsychotic medications neither improves patient outcomes nor relieves system burdens. Conclusion: Combating delirium requires a transformation of the organizational culture within the ICU. Implementing the "Awake and Walking ICU" concept significantly improves patient outcomes, mitigates the socio-economic impact of Post-Intensive Care Syndrome (PICS), and effectively protects nursing staff from severe occupational burnout.