PICOT Quiet time decrease the incidence of ICU delirium

Will strict enforcement of quiet time decrease the incidence of ICU delirium in adult critical-care patients?

The Problem

Based on my practice as a nurse, it has occurred that despite the high quality of care provided in the ICU for elderly patients, there is a high rate of delirium. This has led to undesired patient outcomes that need to change if patients are to attain satisfying outcomes. There is a need to make sure that a conducive environment has been provided to patients in the ICU. One of the ways to ensure this is by providing a quiet environment. My practice area is clinical in nature, which means that I work directly with the patients.

The practice issue was identified through unsatisfactory patient outcomes and having wide variations in practice. It was identified that patients who had a quiet environment in the ICU had reduced rates of delirium as compared to those where quiet periods were not observed. This prompted the desire to understand the importance of having a quiet environment in the ICU amongst the older adults.


Lim (2018), a clinical nurse specialist, conducted a literature review to determine the effectiveness of quiet time interventions in the ICU to improve the sleep of the patients. It was established that the quiet time interventions in the ICU could help in improving the sleep quality of the patients leading to better psychological effects for the patients. Stafford, Haverland, & Bridges (2014) also argue that there is a connection between having quiet times in the ICU to reduced rates of delirium. To analyze the PICOT question extensively, it is important to conduct a literature search based on the question. The terms ICU and adults must form part of the search to narrow the search results. Consequently, the terms delirium and scheduled quiet time are important in narrowing the search results to ensure only those results that are relevant to the question are attained.


Lim, R. (2018). Benefits of quiet time interventions in the intensive care unit: a literature review. Nursing Standard (2014+), 32(30), 41.

Stafford, A., Haverland, A., & Bridges, E. (2014). Noise in the ICU. AJN The American Journal of Nursing, 114(5), 57-63.

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