Detecting Delirium: The Missed Medical Emergency

Abstract Background Delirium is among the most common of medical emergencies with approximately 1 in 5 patients aged 65 and above presenting with or developing delirium, during their acute hospital admission. Delirium is more common in certain patient groups including those with hip fractures, dementia, previous delirium, frailty and other comorbidities. It is associated with poorer outcomes and complications. Delirium also has the potential to cause significant patient and carer stress. Despite the significance of delirium, it is frequently underdiagnosed. It can be prevented and treated if it is identified early. As per the National Dementia Office all acute Hospitals have to complete the Delirium care algorithm for all patients aged 65 years and above, admitted to hospital or who have any known risk factors for delirium. Methods The Delirium Multidisciplinary Care Bundle was rolled out across the hospital with education provided both face to face and via eLearning. Using the Quality Care Metrics (QCM) delirium indicator and a locally developed audit tool, medical and nursing records where reviewed to identify the level of concordance with the Delirium Multidisciplinary Care Bundle. Results The gradual increase in the compliance in use of the care bundle reached up to hundred percent. The bundle use was audited utilising the Quality Care Metrics (QCM) with the delirium indicator showing an improvement of an average of 60-80% hospital-wide. The hospital-wide audit on the compliance of the delirium care bundle was conducted and identified that compliance on the bundle had improved to 60-100%. Conclusion Continuous evaluation, monitoring and improvement plans are in place. This will be further supported by providing multiple methods of education delivery throughout the organisation to meet the needs of all learners. Ultimately continuing to improve delirium detection and management for our patient group.