Intensive care unit environment

The speciality of intensive care medicine was developed as a consequence of the poliomyelitis epidemic of the 1950s, when widespread mechanical ventilation was required. Since then the technology available to support the critically ill patient has become more sophisticated and complex, and the importance of intensive care units (ICUs) in today’s healthcare system is without question. In 1994, Critical Care Medicine reported that nearly 80% of all Americans will experience a critical illness or injury, either as the patient, family member, or friend of a patient, and that ICUs occupy only 10% of inpatient beds, but account for nearly 30% of acute care hospital costs. However, the ICU is a potentially hostile environment to the vulnerable critically ill patient. In addition to the physical stress of illness, pain, sedation, interventions, and mechanical ventilation, there are psychological and psychosocial stressors perceived by these patients. One of the additional factors is the ICU environment, which is also thought to contribute to the syndrome known as ICU psychosis/delirium. Frequently reported stressful environmental factors are noise, ambient light, restriction of mobility, and social isolation.