Delirium, a serious condition that is a medical emergency, is experienced by thousands of Australians in hospital each year.
Delirium is a sudden change in a person’s mental state, characterised by disturbed consciousness, attention, cognition and perception. Patients with delirium may seem confused, restless and agitated, or quiet and withdrawn.
About 10% of Australians over 70 have delirium at presentation to hospital, and a further 8% develop delirium while in hospital – but the condition is under-recognised in Australian hospitals, and many cases of delirium are missed, which could have been prevented.
The Delirium Clinical Care Standard complements other Commission initiatives, including the resource A better way to care: safe and high quality care for patients with cognitive impairment (dementia and delirium) in hospital and the national Caring for Cognitive Impairment campaign.
The Delirium Clinical Care Standard is a small number of nationally agreed recommendations (quality statements) that describe the care that should be provided to patients at risk of, or with delirium.
Chair of the Commission Board, Professor Villis Marshall said: “The Delirium Clinical Care Standard aims to ensure that patients who arrive at hospital with delirium receive the best possible treatment, and that strategies are in place to swiftly identify patients who are at risk of developing delirium, so that preventive care measures can be put in place.
“Delirium is an acute change in mental status that can be a frightening and isolating experience for patients and distressing for their loved ones and carers – it disturbs consciousness and interferes with the ability to communicate, focus attention and think clearly – making it an important safety and quality issue for all Australian hospitals.
“It is important to distinguish delirium from other conditions like dementia and to investigate it properly, because it can be the only sign of an acute, underlying, serious illness,” Professor Marshall said.
Launched as part of the Australasian Delirium Association third Biennial Conference in Sydney, the Delirium Clinical Care Standard guides clinicians and health services to provide high quality care, and supports patients and their carers by detailing the care they can expect, regardless of where in Australia they are treated.
Conference chair and chair of the Commission’s Delirium Clinical Care Standard Topic Working Group, Associate Professor Gideon Caplan said: “Compared with other older patients in hospital, those with delirium have poorer outcomes, including increased mortality, more adverse events such as falls, infections and pressure injuries, an accelerated rate of cognitive and functional decline, longer hospital stays, more unplanned re-admissions and increased early entry to residential aged care facilities – making it a critical issue affecting thousands of Australians.
“The Delirium Clinical Care Standard is an important national approach to providing high quality care for people with, or at risk of, delirium.”
The Commission has included specific cognitive impairment (including delirium and dementia) items in the draft version 2 of the National Safety and Quality Health Service (NSQHS) Standards.