Which non-drug steps help most to prevent sepsis delirium?

The strongest non-drug lever is not a gadget or a supplement. It is preventing and treating the sepsis itself, plus basic orientation, sleep, and nutrition care.

The retrieved evidence is thin on this exact question. Only one record directly addresses non-drug delirium prevention in sepsis, and it is a 2020 expert review, not a trial [1]. It lists the practical bundle: glasses and hearing aids, clocks and calendars, fewer room changes, consistent caregivers, protected sleep, pain control, family presence, less noise, fewer medications, early mobilization, mental activity, adequate oxygen, nutrition, and fluids [1]. It also states plainly that drug options for preventing or treating delirium remain limited [1]. That is the whole of the direct evidence here.

One adjacent finding matters for a septic patient. In hospitalized elderly people, 16% of those with sepsis developed swallowing difficulty without other known risk factors, and 35% of that group died [2]. Swallowing trouble blocks the food and fluid part of the bundle and raises aspiration risk. That is a reason to have swallowing checked, not a proven delirium fix.

This retrieval has no randomized trial of any single non-drug measure against delirium in sepsis, and nothing on which measure matters most. Those gaps are the search, not the world.

My call: build the basic bundle and treat the sepsis and swallowing problem aggressively; no single non-drug step is proven superior. Confidence: low, because the direct evidence is one review, not trials.