Delirium is a cognitive disorder with acute onset and fluctuating course, and it is commonly observed in critically ill patients. Delirium features reduced ability to pay attention, disorientation, and impaired of memory, language, judgement and perception (Association, 2013). The incidence of Delirium varies between 20 and 90 % in patients in the intensive care unit (ICU) (Burry et al., 2017, Mitchell et al., 2017, Lee et al., 2018).

Delirium etiology is associated with predisposing and precipitating factors, which are also considered not modifiable and modifiable (Henao Castaño and Amaya Rey, 2015, Mart et al., 2021). Some predisposing factors are age (≥50 years old), antecedents of diabetes, atrial fibrillation, chronic kidney disease, arterial hypertension, and elevation of biomarkers (Mart et al., 2021, Yamamoto et al., 2020). Precipitating factors are mechanical ventilation, sedative, pain, dehydration, stress, sleep-wake cycle disruption, medical devices, and physical immobilization (Henao Castaño and Amaya Rey, 2015, Wang et al., 2018, Barnes-Daly et al., 2018).

Moreover, delirium prevention and treatment could be done through the non-pharmacological management of modifiable factors, thus recommended by the German (Baron et al., 2015), Danish (Fonsmark et al., 2015;62(4):C5052.), Chinese (Tang et al., 2019), American (Devlin et al., 2018), and Latin American and Iberian guidelines (Celis-Rodríguez et al., 2020). However, non-pharmacological care lacks strong supporting evidence, for which it is essential to develop more studies with experimental designs that test this care.

Thus, non-pharmacological care is focused on pain control, spontaneous wake-up and breathing, delirium assessment, early mobility, cognitive stimulation, occupational therapy, and increasing family time within the ICU. Nurses are at the best position in communicating with and providing direct care to critically ill patients (Karabulut and Aktas, 2016, Donovan et al., 2018).

Hence, a nursing intervention called “Dynamic Delirium” (DyDel) was built following Sidani and Braden’s recommendations (Sidani and Jo, 2013). Thus, two scoping reviews were developed, from the theoretical approach with the nursing theory “Dynamic Symptoms Model” (Gómez Tovar and Henao Castaño, 2020) and from the empirical approach with the scientific evidence of non-pharmacological care (Gómez Tovar and Henao Castaño, 2021).

DyDel includes care according to the patients' physiologic, psychological, spiritual, social and environmental antecedents and the experience and trajectory of delirium, as the theory's authors propose (Brant et al., 2016). Therefore, this research aims to determine the effectiveness of DyDel, compared to daily care, for reducing the incidence and duration of delirium in patients admitted to adult ICUs.