Objective To assess the effect of ESCAPE strategy in the management of delirium in patients with mechanical ventilation. Methods One hundred and sixty-five patients receiving mechanical ventilation admitted in ICU were randomly divided into a control group and an experimental group with the assistance of random number software.The control group （n=79） received ICU routine nursing care, including observation of vital signs, ventilator and circulation monitoring, routine analgesia and sedation care,drug side effects and organ function monitoring. The experimental group （n=86） received ESCAPE strategy-based care in addition to routine nursing, including early mobility exercise, sleep management, daily awaking along with spontaneous breathing test, psychosis evaluation, emotional support and management of analgesia and sedation. The incidence and duration of delirium, doses of analgesic and sedative drugs, duration of mechanical ventilation, length of ICU stay were compared between the two groups. Results The incidence rate and duration of delirium, doses of analgesic and sedative drugs, duration of mechanical ventilation, length of ICU stay in the experimental group were significantly lower and shorter than those in the control group （P＜0.05,P＜0.01）. Conclusion ESCAPE strategy is effective in delirium management of mechanically ventilated patients. It could shorten the duration of delirium, and improve the quality of clinical nursing care.