Delirium

Patients with delirium are at increased risk of harm but measures can be taken to improve safety for both patients, carers and staff.

Older people and people with dementia are at a higher risk of delirium. The prevalence of delirium in people on medical wards in hospital is around 20-30%, and 10-50% of people having surgery develop delirium.

Those who develop delirium are more likely to have an increased length of stay, develop dementia, suffer hospital-acquired complications and are at increased risk of death 1

Delirium is under-reported in the UK 1 yet implementing preventative delirium care bundles, such as those in this section, have been shown to reduce the prevalence of delirium.

Increasing awareness

Increasing the awareness of delirium among patients and carers should improve under-reporting and empower patients and carers to support healthcare staff in recognising delirium and preventing factors which increase the likelihood of delirium developing. A Delirium patient leaflet, produced by The Royal College of Psychiatrists, includes advice on what to expect, practical tips for helping patients with delirium and expectations for recovery and prognosis.

Interventions

Multi-component interventions and care bundles are frequently introduced to prevent delirium. A systematic review of 19 studies of the use of these interventions demonstrated that these are effective within a secondary care setting. This provides an evidence base for the introduction of such strategies in these settings.

One such multi-component intervention is described in Delirium: diagnosis, prevention and management from NICE. It includes recommendations for risk factor assessment, early indicators of delirium and tools to be used for diagnosis of delirium.

References

  1. NICE. Delirium: diagnosis, prevention and management. 2010.  Accessed 15th April 2013

All resources on delirium