Assessment and management of delirium in a tertiary hospital-Improvements in cognitive screening and use of non-pharmacological strategies with a multidisciplinary approach
© 2024 AJA Inc’..
OBJECTIVE: This series of audits aimed to determine current best practice in delirium management in a tertiary teaching hospital and to identify strategies to improve the quality of care in delirium with a focus on prevention.
METHODS: We completed a series of audits following the formation of the Cognitive Impairment Reference Group, a multidisciplinary team that was created to implement delirium management guidelines and monitor compliance. Audit 1 focused on antipsychotic use in patients aged 66 years and older. Audit 2 reviewed delirium care in the Acute Medical Ward. Audit 3 included ethnographic data and investigated the use of non-pharmacological methods to prevent and manage delirium in the Geriatric Ward. Two years on, Audit 4 is a repeat of Audit 1.
RESULTS: There were improved rates of cognitive screening between Audits 2 and 3 from 65% n = 40 to 86% n = 102, respectively. Most patients had one form of non-pharmacological strategy in place to prevent delirium however few had a multicomponent approach. Fewer patients were prescribed benzodiazepines alongside antipsychotics 28.57% n = 35 in Audit 1 compared to Audit 4 12.5% n = 32.
CONCLUSIONS: Improved quality of care in delirium management is achievable via a co-ordinated multidisciplinary approach. These audits demonstrated improvements in both rates of cognitive screening, and use of non-pharmacological strategies prior to antipsychotic medication use and better adherence to guidelines for antipsychotic prescribing. Areas for further development in delirium prevention include the uptake of screening and individualised non-pharmacological strategies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Australasian journal on ageing - 43(2024), 1 vom: 06. März, Seite 175-182 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Clarke, Emily [VerfasserIn] |
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| Links: |
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| Themen: |
Aged |
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| Anmerkungen: |
Date Completed 28.03.2024 Date Revised 28.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ajag.13266 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368068315 |
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| 245 | 1 | 0 | |a Assessment and management of delirium in a tertiary hospital-Improvements in cognitive screening and use of non-pharmacological strategies with a multidisciplinary approach |
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| 500 | |a Date Revised 28.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 AJA Inc’. | ||
| 520 | |a OBJECTIVE: This series of audits aimed to determine current best practice in delirium management in a tertiary teaching hospital and to identify strategies to improve the quality of care in delirium with a focus on prevention | ||
| 520 | |a METHODS: We completed a series of audits following the formation of the Cognitive Impairment Reference Group, a multidisciplinary team that was created to implement delirium management guidelines and monitor compliance. Audit 1 focused on antipsychotic use in patients aged 66 years and older. Audit 2 reviewed delirium care in the Acute Medical Ward. Audit 3 included ethnographic data and investigated the use of non-pharmacological methods to prevent and manage delirium in the Geriatric Ward. Two years on, Audit 4 is a repeat of Audit 1 | ||
| 520 | |a RESULTS: There were improved rates of cognitive screening between Audits 2 and 3 from 65% n = 40 to 86% n = 102, respectively. Most patients had one form of non-pharmacological strategy in place to prevent delirium however few had a multicomponent approach. Fewer patients were prescribed benzodiazepines alongside antipsychotics 28.57% n = 35 in Audit 1 compared to Audit 4 12.5% n = 32 | ||
| 520 | |a CONCLUSIONS: Improved quality of care in delirium management is achievable via a co-ordinated multidisciplinary approach. These audits demonstrated improvements in both rates of cognitive screening, and use of non-pharmacological strategies prior to antipsychotic medication use and better adherence to guidelines for antipsychotic prescribing. Areas for further development in delirium prevention include the uptake of screening and individualised non-pharmacological strategies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aged | |
| 650 | 4 | |a antipsychotics agents/therapeutic use | |
| 650 | 4 | |a delirium/epidemiology | |
| 650 | 4 | |a delirium/prevention and control | |
| 650 | 4 | |a patient care team | |
| 650 | 7 | |a Antipsychotic Agents |2 NLM | |
| 700 | 1 | |a Newman, Ellie |e verfasserin |4 aut | |
| 700 | 1 | |a Dravid, Madhu |e verfasserin |4 aut | |
| 700 | 1 | |a Ricciardello, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Jones, Emma |e verfasserin |4 aut | |
| 700 | 1 | |a Caudle, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Kilshaw, Lucy |e verfasserin |4 aut | |
| 700 | 1 | |a Hilmi, Samantha |e verfasserin |4 aut | |
| 700 | 1 | |a Flicker, Leon |e verfasserin |4 aut | |
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