NSQHS - Standard 5.29-5.30: Preventing delirium and managing cognitive impairment
Delirium is an acute change in mental status that is common among older people in hospital. Characterised by a disturbance of consciousness, attention, cognition and perception that develops over a short period of time (usually hours to a few days), delirium is a serious condition and is associated with increased risk of harm. The frequency of delirium in the emergency department is reported to be 10% - 13% among older patients and increases to 22% - 42% in the inpatient setting (Lee, 2020).
Articles to get you thinking about Standard 5.29 - 5.30:
Delirium Clinical Care Standard - Australian Commission on Safety and Quality in Health Care.
Baller, E. B., Hogan, C. S., Fusunyan, M. A., Ivkovic, A., Luccarelli, J. W., Madva, E., Nisavic, M., Praschan, N., Quijije, N. V., Beach, S. R., & Smith, F. A. (2020). Neurocovid: Pharmacological recommendations for delirium associated with COVID-19. Psychosomatics, 61(6), 585–596. https://doi.org/10.1016/j.psym.2020.05.013
Chia, J., Eeles, E. M., Tattam, K., & Yerkovich, S. (2020). Outcomes for patients with delirium receiving hospital-in-the-home treatment: An Australian perspective. Australasian Journal on Ageing, 39(2), e215–e219. https://doi.org/10.1111/ajag.12768
Grealish, L., Todd, J. A., Krug, M., & Teodorczuk, A. (2019). Education for delirium prevention: Knowing, meaning and doing. Nurse Education in Practice, 40, 102622. https://doi.org/10.1016/j.nepr.2019.102622
Lee, S., Gottlieb, M., Mulhausen, P., Wilbur, J., Reisinger, H. S., Han, J. H., & Carnahan, R. (2020). Recognition, prevention, and treatment of delirium in emergency department: An evidence-based narrative review. The American Journal of Emergency Medicine, 38(2), 349–357. https://doi.org/10.1016/j.ajem.2019.158454
Shenvi, C., Kennedy, M., Austin, C. A., Wilson, M. P., Gerardi, M., & Schneider, S. (2020). Managing delirium and agitation in the older emergency department patient: The ADEPT tool. Annals of Emergency Medicine, 75(2), 136–145. https://doi.org/10.1016/j.annemergmed.2019.07.023
Wilcox, M.E., Girard, T.D., & Hough, C.L. (2021). Delirium and long term cognition in critically ill patients. BMJ ,373 https://doi.org/10.1136/bmj.n1007
International experts have developed consensus on a core set of research outcomes for delirium, including delirium occurrence and reoccurrence, severity, duration, cognition, emotional distress, and health-related quality of life.
Rose, L., Burry, L., Agar, M. et al. (2021). A core outcome set for studies evaluating interventions to prevent and/or treat delirium for adults requiring an acute care hospital admission: an international key stakeholder informed consensus study. BMC Medicine 19(143). https://doi.org/10.1186/s12916-021-02015-3
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