Results From A Snapshot Survey Of Delirium Prevalence, Detection And Care In Hospitals In Ireland On World Delirium Awareness Day

• Published in: Age and ageing 2024-09, Vol.53 (Supplement_4)
• Main Authors: Azizi, Zahra, Bohane, Teresa, Dukelow, Tim, O'Regan, Niamh, Harkin, Eithne, Donnellan, Christina, Carroll, Ida, Costello, Maria, O'Reilly, Susan, Noonan, Claire, Timmons, Suzanne
• Format: Article
• Language: English
• Subjects: Attention deficits; Causality; Clinical outcomes; Delirium; Dementia; Dementia disorders; Emergency medical care; Emergency services; Encephalopathy; Geriatric wards; Geriatrics; Hospitals; Intensive care; Intensive care units; Medical screening; Morbidity; Polls & surveys; Prevalence; Surveys; Training
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afae178.009

Abstract Background Delirium, an acute encephalopathy characterized by acute onset, fluctuation, and attention deficits, is associated with increased mortality and morbidity, and with precipitation or worsening of dementia. Thus, delirium prevention, timely detection, and appropriate management are crucial. Methods On World Delirium Awareness Day (15th March 2023), a global survey was assessed delirium prevalence and care. A senior clinical staff member on each participating ward reported on delirium prevalence at 8AM and 8PM, and on usual ward practice; data was entered into an online survey by a data collector (typically an on-site clinician, visiting several wards to record data). This study reports data from Irish hospitals. Results In total, 132 wards from 15 hospitals across Ireland participated. Delirium prevalence, using a formal assessment tool, was 15.9% across all wards, highest in geriatric wards (20.5%). However, on wards where 'personal judgment' to detect delirium was utilized, the prevalence rate was 11.5%, implying that delirium may be missed on these wards. Intensive care units (76.2%), geriatric wards (70%), and Emergency Departments/Acute Medical Units (ED/AMUA; 66.7%) had the highest rate of written delirium protocols. Similarly, staff training (51.5% overall), was highest in ED/AMAU (88.9%), followed by general surgical (66.7%), and geriatrics wards (60%). In contrast, only 30.8% (4/13) of non-acute wards had provided staff with delirium training in the preceding year. Having at least one training session in the preceding year was associated with higher use of formal delirium tools (18.8% versus 60.3%). Wards reported staff training/educating as the main care improvement priority; 72.7% of wards identified lack of time to train staff as a key barrier. Conclusion Delirium is prevalent in Irish hospitals and appears under-detected without formal screening. Training staff in delirium-related skills, including the use of simple screening tools for delirium detection and causation, could be paramount to improving patient outcomes.