Discombobulated by delirium: A scoping review of integrated interdisciplinary approaches to delirium in Australian inpatients

Objective To conduct a scoping review of current evidence for an integrated multidisciplinary approach to preventing and managing delirium in the Australian inpatient context. Methods A systematic literature search was conducted using several databases to include primary studies, meta-analyses and guidelines surrounding integrated team approaches to delirium in the inpatient hospital setting in Australia. PRISMA scoping review guidelines were utilised for the fourteen studies meeting inclusion criteria. Results The review demonstrates the stark absence of quality studies such as randomised control trials (RCTs) in guiding the detection, treatment and risk reduction of delirium. However, emerging themes included the importance of an integrated multidisciplinary model of care, comprehensive geriatric assessment, team education and cohesion as well as the availability of clinical experts including psychogeriatricians. Conclusions The current evidence base though extremely limited, does support the integration of psychogeriatric services as part of a multidisciplinary approach to prevent delirium and improve management once diagnosed. Ongoing research, particularly RCTs, is necessary to continue to develop and validate specific, evidenced-based approaches to delirium management in the Australian hospital setting.