Examples of Delirium Prevention Tools

An example of a delirium intervention tool is the delirium
risk screen sticker from the Victorian Government Health Information website at this updated link 

I’ve highlighted areas of interest such as the logo which of
course can be modified to suit your institution. The illness severity risk
factor is an issue our delirium prevention committee is wrestling with at the
moment. We’re not exactly sure how to operationalize it yet. Our group prefers
the CAM-ICU instead of the CAM but you can use either. There are other
screening instruments but the CAM type assessments are validated and probably
the easiest and quickest to use[1]. As for the AMTS (stands for Abbreviated
Mental Test Score), see the link for a quick look, http://en.wikipedia.org/wiki/Abbreviated_mental_test_score.
Incidentally, the HELP site (see link at the right) once again is listing The
Sweet 16 quick cognitive assessment, now with a disclaimer. Its open access but
you need to acknowledge properly to Dr. Sharon Inouye [Update: The Sweet 16 is no more-J.A.]. Our group has also
wrestled with the choices out there for quick assessments that are validated
for identifying pre-existing cognitive impairment in the elderly as a risk
factor for delirium. I welcome your comments on what you’ve found to be most
helpful and efficient. If you have a delirium brochure for families and carers,
that’s terrific. The Victorian Government Health Information site posts one. Consulting
a geriatrician may be an option at some hospitals. Our hospital has recently
allied with Nurses Improving Care for Healthsystem Elders (NICHE) and a
consultant is now working with our nurses. See the NICHE link on the right for
more information.

Let’s have a look at one section of the short guidelines
from the Victorian site:

This is page 2 of 2 and it’s short and sweet. There are
regional acronyms you could modify or omit as needed. ATSI stands for
Aboriginal and Torres Strait Islander and CALD stands for Culturally and
Linguistically Diverse.

I think these are outstanding examples of the work that’s
being done in other parts of the world about delirium prevention and deserve
replication with suitable adaptations for other hospitals and healthcare
organizations.

1.            Wong, C.L., et al., Does this patient have delirium?: value of
bedside instruments.
JAMA, 2010. 304(7):
p. 779-86.

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