None listed
Conditions
Brief summary
Delirium occurs commonly in hospitalised older patients and is frequently under-diagnosed and mistreated. There are two major shortfalls in Emergency Department (ED) care related to delirium: failure to diagnose and treat already established delirium, and failure to prevent the development of delirium. This study will test whether a screening process we have developed to identify delirium risk, coupled with the use of diagnostic and preventative measures in the ED and during hospital admission, will address these shortfalls.
Interventions
A risk assessment score based on nursing assessment, prompting a standardised diagnostic and management pathway. This is a locally developed and tested delirium screening score to be applied by based on clinical findings at the initial nurse assessment in ED. It takes approximately 5 minutes to complete. If the patient screens positive on this score, it triggers medical staff to perform a diagnostic Confusion Assessment Method and follow a set of action plans for diagnostic workup and prevention
A risk assessment score based on nursing assessment, prompting a standardised diagnostic and management pathway. This is a locally developed and tested delirium screening score to be applied by based on clinical findings at the initial nurse assessment in ED. It takes approximately 5 minutes to complete. If the patient screens positive on this score, it triggers medical staff to perform a diagnostic Confusion Assessment Method and follow a set of action plans for diagnostic workup and prevention/management of delirium e.g. medication review. These action plans will be prompted by the visual cue of placing an end of bed warning card with the patient, which will stay with them throughout their admission. The intervention period will last for six months.
Sponsors
Fremantle Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients aged 65 years or more who are to be admitted to any inpatient unit via the ED
Exclusion criteria
Patients with critical illness requiring acute resuscitation Patients who are unable to speak English with no professional interpreter present
Outcome results
None listed