What question did this study set out to answer?

The aim is to evaluate existing evidence on non-pharmacological strategies for preventing delirium in mechanically ventilated ICU patients.

February 8, 2026

Summarising the Best Evidence for Non‐Pharmacological Prevention of Delirium in Mechanically Ventilated ICU Patients

Key Points

The aim is to evaluate existing evidence on non-pharmacological strategies for preventing delirium in mechanically ventilated ICU patients.
Applied evidence summary reporting standards and '6S' pyramid model
Conducted a literature search across key databases and webpages
Included various study types such as guidelines, reviews, and trials
Eighteen documents were included in the assessment
Developed 26 evidence-based recommendations—20 Grade A and 6 Grade B
Identified six domains for delirium prevention including environment control and traditional Chinese medicine

Abstract

ABSTRACT Background Delirium is a significant concern for mechanically ventilated patients in intensive care units. Non‐pharmacological strategies may help prevent delirium, but without a standard protocol, interventions are inconsistent. Aim This study assessed existing evidence on non‐pharmacological interventions for decreasing delirium in mechanically ventilated ICU patients. Study Design We applied evidence summary reporting standards and the ‘6S’ pyramid model, searching key databases and webpages with a top‐down focus on high‐level evidence about non‐pharmacological delirium prevention. The search covered literature published up until March 13, 2025. Results Eighteen documents were included: two guidelines, three expert consensuses, seven systematic reviews, three randomised controlled trials and three clinical decision analyses. The integrated evidence was grouped into six domains: assessment and diagnosis, positive internal experience, environment control, physical function recovery, traditional Chinese medicine (including five‐animal play, five‐element music therapy and acupuncture) and bundled interventions. This resulted in the development of 26 evidence‐based recommendations—20 Grade A (strong recommendation) and six Grade B (weak recommendation), indicating a high degree of consensus and clinical feasibility. Conclusions We synthesised 26 of the highest‐quality studies from six domains to generate a comprehensive framework for non‐pharmacological delirium prevention in mechanically ventilated ICU patients. These evidence‐based suggestions provide practical clinical advice that healthcare professionals can adapt based on local resources and clinical contexts to guarantee safety and efficacy. Relevance to Clinical Practice This study reviewed the best evidence for the non‐pharmacological prevention of delirium in mechanically ventilated ICU patients, from which it derived a comprehensive framework for clinical practice. This framework can reduce the frequency and length of delirium episodes, improve patient health outcomes and improve overall nursing quality. Registration This review was submitted by Fudan University's Evidence‐Based Nursing Center with registration number ES20246510.

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