INNOVATIVE ORGANIZATIONAL STRATEGIES IN MANAGING ICU DELIRIUM: MITIGATING NURSING BURNOUT AND IMPROVING CRITICAL CARE QUALITY

Julia Paczyna; Ewa Jachimczak; Ewa Wojtanowska; Paulina Jaruga; Karolina Grodkowska-Szukała; Julia Kozicka; Marcin Mazur; Vanessa Gąsiorowska

doi:10.31435/ijitss.2(50).2026.5959

Authors

Julia Paczyna Regional Specialized Hospital No. 4, Bytom, Poland https://orcid.org/0009-0006-5485-7167
Ewa Jachimczak University Hospital in Kraków, Poland https://orcid.org/0009-0009-6899-3460
Ewa Wojtanowska Medical University of Łódź, Poland https://orcid.org/0009-0007-4813-9473
Paulina Jaruga Regional Specialized Hospital No. 4, Bytom, Poland https://orcid.org/0009-0009-3178-3785
Karolina Grodkowska-Szukała Municipal Hospital in Zabrze, Poland https://orcid.org/0009-0000-6179-7242
Julia Kozicka Medical University of Łódź, Poland https://orcid.org/0009-0003-8138-6231
Marcin Mazur Medical University of Łódź, Poland https://orcid.org/0009-0008-2408-2107
Vanessa Gąsiorowska Our Lady of Perpetual Help Hospital in Wołomin, Poland https://orcid.org/0009-0008-2420-627X

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5959

Keywords:

Delirium Management, Nursing Burnout, Intensive Care Unit, Organizational Innovation, ABCDEF Bundle, Critical Care Quality

Abstract

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.

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