Early delirium identification and management. The 20,000 days campaign. Health system improvement guide.

<ul><li> Delirium in hospitalised patients is common. A study conducted in 2010 by Counties Manukau Health found that 13.5% patients admitted to two Middlemore Hospital orthopaedic wards (Wards 10 and 11) developed delirium over a four-week period.</li><li>The existing delirium management guideline at Counties Manukau Health was inadequate and underutilised.</li><li>Patients with delirium are at risk of injury, prolonged length of stay, poor outcome and increased mortality.</li><li>Delirium can often mask more serious underlying conditions or complications.</li><li>Patients with delirium are often poorly identified and poorly managed, and staff tended to view patients with delirium as ‘difficult’.</li><li>Strategies for managing patients with delirium frequently involved a watch*. The watches were limited in scope and did not support best practice for delirium management as laid out in the Counties Manukau Health watch procedure.</li><li>Improved management of delirium would result in a reduction in the length of stay and improved outcomes for patients.</li><li>An acute episode of delirium is a predictor for future events. Early identification of patients who are at risk of acute delirium will ensure that appropriate treatment is initiated for subsequent hospital admissions.</li></ul><p dir="ltr"><i>*One to one supervision of a patient to prevent behaviours which may lead to the patient absconding, or injuring themselves or others. It may also involve providing assistance with activities of daily living.</i></p>