Icon for Key Principle 2

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.

Quality measures and Expected outcomes

Australian guidelines for the management of delirium in older people recommend that risk of delirium should be assessed in all older persons admitted to a health care setting and promote the use of multifactorial prevention strategies to reduce the incidence, duration and severity of delirium (1).

CHOPs recommend the following quality measures and expected outcomes of implementation of the key principle of delirium risk identification and preventive measures.

Quality measures

System measures

  • Delirium Risk Assessment Tool (DRAT) tool in place
  • Evidence of standardised process for identification and management of risk

Patient measures

  • Delirium risk assessed, documented and prevention strategies in place

Staff measures

  • Staff are aware of delirium risk and prevention strategies

Expected outcome

  • Delirium risk is assessed and the level of risk communicated and clearly outlined in standardised documentation.
  • Older people identified as “at risk” of developing delirium will have primary preventive (environmental/ clinical practice) strategies implemented.
  • Cognitive screening will be repeated for at risk individuals if there is a sudden change in behaviour or deterioration in condition of the older person. 


  1. 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.