Citations 2
Delirium assessment, management and barriers to effective care across Scotland: A secondary analysis of survey data from World Delirium Awareness Day 2023
Naeem, Fariha , Penfold, Rose , Soiza, Roy L. , Haken, Rebecca von , Liu, Keibun , Nydhal, Peter, Quinn, Terry , Lindroth, Heidi
Journal of the Royal College of Physicians of Edinburgh | November 29, 2024 | Volume: 55 | Issue: 1 | Pages: 6-13
Introduction: Delirium is a common, severe neuropsychiatric syndrome in hospitalised older adults. We evaluated use of validated delirium assessment tools, adherence to national guidelines and prevalence and management of delirium across Scotland, identifying barriers to effective care. Methods: Secondary analysis of national survey data, collected by participating clinicians on World Delirium Awareness Day (15 March 2023). Results: Among 120 responses (3,257 patients), the 4AT was the most frequently used assessment tool (75%), while 14% of units reported using clinical judgement alone. The delirium assessment rate was 74%, with a prevalence of 22% at 8 am. Management protocols varied, with frequent routine non-pharmacological interventions including pain management (88%), hydration (87%) and open family visiting (80%). Barriers to delirium care included insufficient staffing and training. Conclusion: While many hospital settings follow national delirium guidelines, some still rely on clinical judgement for assessment, with variability in management protocols and practices. We have highlighted key barriers to effective delirium care in Scotland.
A world-wide study on delirium assessments and presence of protocols
Nydahl, Peter , Liu, Keibun , Bellelli, Giuseppe , Calle, Gabi Heras-La, Hoffmann, Magdalena , Jeitziner, Marie‐Madlen , Krewulak, Karla D. , Paulino, Maria Carolina , Haken, Rebecca von , Group, the WDAD Study, Abdalgany, Ahmed Gaber Ahmed, Aburaas, Amjad, Albakosh, Bashir Abobaker, Alhamdan, Hamza Ismail Ahmad, Aljbali, Akram Waled Rajab M, Al-Kandari, Fareeda, Anders, Daniel, Anderson, Marsali, Ashkenazy, Shelly , Avelino, Thiago, Bail, Kasia , Bakri, Ashraf , Baroum, Alaa Mohamed Ali , Brendt-Müller, Jennifer, Brobeil, Angelika, Byrnes, Tru , Cahill, Maria, Canelas, Maria Ana , Carroll, Ida, Conley, Amy, Cotton, Shannon A. , Couser, Mandy, Salgado, A., Cusworth, Elizabeth, Cvoro, Vera , Deosaran, Jordanna, Diebels, Merel, Docherty, Elaine A, Dossow, Vera von , Drennan, Megan, Egdeer, Akram Amin, Eichelsheim, Patrick, Elagili, Aissha Ali Saleh, Elsahl, Saifaleslam Jamal, Elshaikh, Hajer Alsadeg Mohammed, Fathi, Azza , Feige, Melanie, Fiest, Kirsten M. , Fong, Marleta Irene Joy, Fuchita, Mikita , Gaffney, Carol, Vich, Carola Giménez-Esparza, Feldmann, Nicole , Fitzpatrick, Neasa , Fong, Marleta Irene Joy, Goldberg, María Adela , Golüke, Nienke M.S. , Graaf, Marinette van der , Groenewald, Engelina , Gross, Renate , Segers, Camilla Grube, Hadi, Renate, Hamdan, Qusai Ahmad Hasan, Hamida, Bahaeddin Ben, Hamza, Monalyce, Hopkins, Jane , Hopkins, John , Jeyaseelan, Arveen , Kadhim, Ali Jawad, Kohler, S., Kooken, Rens , Khutwah, Ayman Salim Abu, Lange, Puck, Liefrink, Sharon, Lin, Yu‐Min , Loo, Shi Pei , Rodrigues, Sara Beatriz Lopes, MacDonald, Allan S., Madders, G, Massaro, Claudia, Maya, Kerri, Manioudaki, Sofia, Stewart, McKenna, Coimbra, Isabel , Miranda, Teresa, Mohamed, Mohamed A. , Mohammed, Mushin Mohammed Elhadi Agbna, Naeem, Fariha , Nam, Mi-Ryeo, Newman, Elaine, Nicol, Renae, Noonan, Claire, Lopes, Maria Inês, Otmani, Zina , O’Reilly, Susan, Ozorio, Valerie, Palakashappa, Jessica, Pandya, Tej , Papadea, Panagiota, Papanikolaou, Metaxia, Pinardi, Elena , Pereira, Inês Filipa Pinto, Premathilaka, Chirantha , Pop‐Purceleanu, Monica , Puchegger, Marlene, Qalhoud, Nouralddeen Mohammed, Raasing, Maike, Ragheb, Dalia Talaat, Ramadan, Nuri, Rubel, Mushabbir Hossain, Sainsbury, Kate, Schimböck, Florian , Schmädig, Roman , Schoon, Yvonne , Sethia, Deepak , Sextl, Edith, Shah, Bhagyesh , Shaout, Dua’a, Sharabi, Alaa Fouad, Shields, Lynn, Smith, Kendall A. , Dam, Linda Smulders-van, Soiza, Roy L. , Spiegler, Andrea, Stocks, Lucy, Sumerauer, Stefan, Tam, Stephanie , Tan, Aik Haw, Tohsche, Peter, Torres, Raquel Gouveia, Toth, Chantal, Tousgaard, Iben, Vogt, Birgit, Walsh, Erica M., Ward‐Stockham, Kristel , Mart, Melinda Webb‐St, Wijnen-Meijer, Mariajne Elisabeth, Zastrow, Inke , Nydahl, Peter , Jeitziner, Marie-Madlen , Krewulak, Karla D , Benbenishty, Julie Sarah , Boogaard, Mark van den , Caplan, Gideon A. , Chung, Chi Ryang , Elhadi, Muhammed , Gurjar, Mohan , Mailhot, Tanya , Morandi, Alessandro , Nawa, Ricardo Kenji , Oh, Esther S , Collet, Marie Oxenbøll , Lindroth, Heidi , Group, the WDAD Study, Abdelmohsen, Sarah Magdy , Aggar, Christina , Alkandari, Farah, Alkaseek, Akram Mohammed , Anders, Daniel, Anderson, Marsali, Blackwood, Bronagh , Brendt-Müller, Jennifer , Burke, Richard, Cacciatore, Stefano , Cahill, Maria, Conley, Amy, Costello, Maria , Diebels, Merel, Elshaikh, Hajer Alsadeg Mohammed, Emme, Christina , Exl, Matthias Thomas , Fong, Marleta Irene Joy, Gaffney, Carol, Fitzgerald, Rachel, Fong, Marleta Irene Joy, Graaf, Mirjam, Segers, Camilla Grube, Hadi, Renate, Hamdan, Qusai, Hetland, Breanna , Hopkins, Jane Adele, Ibrahim, Said A. , Imbrìaco, Guglielmo , Inoue, Shigeaki , Kadhim, Ali Jawad, Kohler, Sabrina, Korompeli, Anna , Krüger, Lars , Lange, Puck, Rodrigues, Sara Beatriz Lopes, MacDonald, Allan, McAndrew, Natalie S. , Mohamed, Mohamed Anwar Abdelsalam, Mohammed, Mushin Mohammed Elhadi Agbna, Mulkey, Malissa , Nakamura, Kensuke , Nam, Mi-Ryeo, Newman, Elaine, Nicol, Renae, Olotu, Cynthia , Ornago, Alice Margherita , O’Reilly, Susan, Penfold, Rose , Pereira, Inês Filipa Pinto, Quinn, Terence J , Raasing, Maike Wm, Rajhans, Prasad Anant , Ramadan, Nuri, Rubel, Mushabbir Hossain, Sainsbury, Kate, Salis, Francesco , Sharabi, Alaa Fouad, Smith, Kendall, Tam, Stephanie, Timmons, Suzanne , Torres, Raquel Gouveia, Tsolaki, Vasiliki , Castro, Roberta Esteves Vieira de , Vogt, Birgit, Walsh, Erica, Wefer, Franziska , Wøien, Hilde , Zazzara, Maria Beatrice
Age and Ageing | June 12, 2024 | Volume: 53 | Issue: 7 | Pages: No page available
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.