This institutional operational guideline converts Ankara Bilkent City Hospital procedure YB.PR.002, Revision 03, into a structured adult ICU framework for pain assessment, analgesia, sedation, agitation, delirium prevention and screening, sleep support, mobility and related safety monitoring.

It includes pain-first care, RASS and the locally revised Riker Sedation-Agitation Scale, CAM-ICU screening, daily spontaneous awakening and breathing coordination, medication principles, delirium prevention, restraint minimization, quality indicators and local implementation.

Important: Educational and operational guidance. Local institutional approval is required before implementation. Medication doses, indications and monitoring must follow current hospital formulary, approved protocols and patient-specific clinical judgement.