Research & Innovation
Publications
A world-wide study on delirium assessments and presence of protocols
PMU Author
Peter Nydahl
All Authors
Peter Nydahl, Keibun Liu, Giuseppe Bellelli, Julie Benbenishty, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabi Heras-La Calle, Magdalena Hoffmann, Marie-Madlen Jeitziner, Karla Krewulak, Tanya Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S. Oh, Marie O. Collet, Maria Carolina Paulino, Heidi Lindroth, Rebecca von Haken,
Journal association
Age and Ageing
Abstract
Background Delirium is a common complication of older people in hospitals, rehabilitation and long-term facilities.Objective To assess the worldwide use of validated delirium assessment tools and the presence of delirium management protocols.Design Secondary analysis of a worldwide one-day point prevalence study on World Delirium Awareness Day, 15 March 2023.Setting Cross-sectional online survey including hospitals, rehabilitation and long-term facilities.Methods Participating clinicians reported data on delirium, the presence of protocols, delirium assessments, delirium-awareness interventions, non-pharmacological and pharmacological interventions, and ward/unit-specific barriers.Results Data from 44 countries, 1664 wards/units and 36 048 patients were analysed. Validated delirium assessments were used in 66.7% (n = 1110) of wards/units, 18.6% (n = 310) used personal judgement or no assessment, and 10% (n = 166) used other assessment methods. A delirium management protocol was reported in 66.8% (n = 1094) of wards/units. The presence of protocols for delirium management varied across continents, ranging from 21.6% (on 21/97 wards/units) in Africa to 90.4% (235/260) in Australia, similar to the use of validated delirium assessments with 29.6% (29/98) in Africa to 93.5% (116/124) in North America. Wards/units with a delirium management protocol [n = 1094/1664, 66.8%] were more likely to use a validated delirium test than those without a protocol [odds ratio 6.97 (95% confidence interval 5.289-9.185)]. The presence of a delirium protocol increased the chances for valid delirium assessment and, likely, evidence-based interventions.Conclusion Wards/units that reported the presence of delirium management protocols had a higher probability of using validated delirium assessments tools to assess for delirium.
Keywords
PROTOCOLS, ENCEPHALOPATHY, ASSESSMENTS, QUALITY IMPROVEMENT, PATIENT SAFETY, DELIRIUM, Older people