PRINCIPLE 2: Delirium risk identification and prevention strategies

Older people will be assessed for delirium risk. Interventions will be put in place for prevention of identified risks. Identified risks will be communicated to the older person, their carer, family and staff involved in their care.

Delirium risk identification and preventive measures

Delirium is a common clinical syndrome characterised by inattention, disorientation, memory loss and acute cognitive dysfunction (1-3). It can affect up to a third of older people admitted to hospital (4).

Delirium is usually caused by an underlying acute illness, which in most cases can be detected and treated (1-3).

Individuals with dementia are at the greatest risk of developing delirium, so it’s vital to identify those with cognitive impairment early, using a cognitive screening tool on admission.

Regular reviews of the at-risk individual should then be used in conjunction with designated prevention strategies.

Key steps in risk identification and prevention

• Delirium risk assessment, performed in conjunction with cognitive screening
• Early identification and management of risk factors for delirium
• Implementation of preventive measures to manage risk factors and promote wellbeing.

References

1. National Institute for Health and clinical Excellence (NICE). Delirium: diagnosis, prevention and management. July 2010.
2. Clinical Epidemiology and Health Service Evaluation Unit, Melbourne Health in collaboration with the Delirium Clinical Guidelines Expert Working Group. Clinical Practice Guidelines for the Management of Delirium in Older People, 2006.
3. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2013.
4. Clinical Excellence Commission (CEC). Safer systems better care - Quality Systems Assessment. Sydney: CEC, 2012.