929 An Audit of the Perioperative Clinical Assessment and Documentation of Delirium in Older Patients Following Vascular Surgery

Abstract Aim Guidelines established by the Centre for Perioperative Care recommend daily screening for delirium using a validated tool such as the 4-AT and proactively documenting delirium in patients aged 65 years and over. This audit evaluated the assessment and documentation of delirium in older patients following vascular surgery. Method Patients aged ≥ 65 years who had undergone vascular surgery in August 2023 were identified. Data was collected retrospectively with access to the Trust electronic patient record system on a bespoke Microsoft Excel spreadsheet and analysis was carried out using SPSS®. Results Of the 51 patients identified, delirium was screened using the 4-AT tool in only 39.2% (n=20) of patients and on average 90 hours post-operatively. The highest documented score was 7 (n=1), with 7.8% (n=4) of patients scoring 1, 2 or 3 and the majority scoring 0 (n=15). The 4-AT was never documented in a consultant-led surgical post-operative review (100%, n=51). Additionally, there were concerns of delirium documented in 7 instances in the post-operative period, with the 4-AT documented in 5 of those instances. Conclusions This audit demonstrates poor compliance with perioperative care standards on screening for delirium using the 4-AT and documenting delirium, highlighting the need to increase awareness and improve the perioperative clinical pathway for older people undergoing vascular surgery. Our recommendations include discussion with stakeholders to identify barriers to assessment and documentation of delirium, (2) use of the mantra: 'Post-op bloods and 4AT' during post-operative reviews, and (3) education of various healthcare professionals in completing the 4-AT proforma on the ward.