Delirium Clinical Care Standard
This clinical care standard aims to improve the prevention of delirium in patients at risk – and the early diagnosis and treatment of patients with delirium.
Delirium is an acute change in mental status that is often triggered by acute illness, surgery, injuries or adverse effects of medicines. Despite being a serious condition that is associated with increased mortality, delirium has been poorly recognised in Australian hospitals and internationally.
Launch of updated Delirium Clinical Care Standard, 2021
The updated Delirium Clinical Care Standard was launched at the Australasian Delirium Association Conference, DECLARED 2021, on Thursday 9 September 2021, by Associate Professor Gideon Caplan, President of the Australasian Delirium Association.
Watch the recording of Professor Caplan's talk below.
Also available are presentations from Professor Susan Kurrle, geriatrician and Curran Chair in Health Care of Older People, University of Sydney and Anne Cumming, Principal Advisor, Cognitive Impairment from the Commission, who discussed what's new in the updated Delirium Clinical Care Standard and what it means in practice.
Contents of the standard and resources
The Delirium Clinical Care Standard is made up of eight quality statements and a set of indicators for safe and appropriate care.
- For consumers, the standard describes the care you should expect to receive when you are at risk of developing delirium or experience delirium.
- For clinicians, the standard provides guidance on the eight evidence-based quality statements from the clinical care standard.
- For health service organisations, the standard describes key components of care that health services can use to guide practice and monitor improvements in care.
Background
About 10–18% of Australians aged 65 years or older have delirium at the time of admission to hospital, and a further 2–8% develop delirium during their hospital stay.
Delirium is more common among older patients, but it also occurs in other age groups. Prevalence is higher in critical care and hospital palliative care settings, and rates in residential aged care services exceed those in the general community.
Prevention is the most effective strategy, but early intervention can also improve outcomes for patients with delirium.
This clinical care standard has been widely implemented in Australian hospitals since it was first released in 2016. The standard builds on other work undertaken by the Commission, such as the cognitive impairment program and the A Better Way to Care resources. In 2019–20, the rate of delirium as a hospital-acquired complication was 35.7 per 10,000 admissions.
The NSQHS Comprehensive Care Standard, Action 5.29 requires health service organisations to incorporate best-practice strategies for the early recognition, prevention, treatment and management of cognitive impairment in their systems of care, including the Delirium Clinical Care Standard.
Evaluation findings
Evaluation of the Delirium Clinical Care Standard was undertaken as part of the review process in 2020. The evaluation found that:
- 98% of respondents reported that the Delirium Clinical Care Standard was relevant to their practice
- 73% reported changes to practice at an organisation level as a result of implementing the Delirium Clinical Care Standard.
Read more about the impact of the Delirium Clinical Care Standard in the evaluation report.
Consultation and endorsement
The process for revising the standard has included consultation with the Delirium Clinical Care Standard Topic Working Group, an open request for public feedback, a targeted consultation process with potential endorsing organisations and internal review through the Commission’s processes.
The standard has been endorsed by a number of key organisations.
Evidence base
A review was carried out to assess consistency with key guidelines released since the standard was first published, including those from the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network, and the current Therapeutic Guidelines (eTG).
Transition to the 2021 Standard
The 2016 Delirium Clinical Care Standard and resources have been superseded by the 2021 Delirium Clinical Care Standard and health service organisations should be implementing the 2021 Delirium Clinical Care Standard. Assessments based on the 2021 Delirium Clinical Care Standard commenced from 1 September 2022, and assessment of some clinical care standards indicators are required.
Questions?
Email ccs@safetyandquality.gov.au.