Delirium: Introduction

Overview

Delirium is a state of confusion that comes on very suddenly and lasts hours to days. It can cause changes in a person’s ability to stay alert, remember, be oriented to time or place, speak or reason clearly. Delirium can be caused by many things including having an infection, recent surgery, various medical conditions, untreated pain, starting, increasing or stopping some medicines, or not eating or sleeping well. Many things can make delirium worse including physical restraints, bed rest, bladder catheters and certain medications (Coalition for Seniors' Mental Health 2017; American Delirium Society 2015).

Delirium is a common problem in hospitalized ICU patients. It is sometimes not recognized or is misdiagnosed as another condition such as dementia or depression. Patients who experience delirium in the hospital (compared to patients without delirium) are more likely to:

• Stay longer in the hospital and have more hospital associated complications.
• Experience higher mortality rates in the hospital and up to six to 12 months later.
• Lose physical function in the hospital and need long-term care after the hospital.
• Develop dementia or similar types of cognitive impairment even if the delirium clears.(American Delirium Society 2015).  

Delirium can be prevented. The most important step in delirium management is early recognition and prevention making it an important strategy for quality improvement (Safer Healthcare Now! 2013).

Goal

To improve the early detection and reduce the incidence of delirium in at risk hospitalized patients in intensive and general care units through implementation of standardized delirium screening and prevention strategies. 

Table of Contents

• Delirium: Discharge Abstract Database
• Delirium: Importance to Patients and Families
• Delirium: Clinical and System Reviews, Incident Analyses 
• Delirium: Measures
• Delirium: Prevention Success Stories
• Delirium: References