Abstract
Introduction
Elderly patients are prone to developing delirium, with this risk being heightened by admission to hospital. In Sunderland hospital all patients are screened on admission by the frailty team, but we suspected cases were being missed later in admission. NICE advocates that delirium is screened and appropriately investigated during a patient's admission. To aid detection, RADAR, a bedside delirium screening tool is completed with each set of observations. RADAR is an effective screening tool, with three to four RADAR screenings per day, RADAR has a 73% sensitivity and a 67% specificity (1).
Method
To determine the effectiveness of the RADAR tool we conducted a retrospective cohort study of 52 patients admitted to a COTE ward in October 2024. We assessed RADAR completion, whether positive responses triggered review, and correlation with delirium diagnosis.
Results
This demonstrated that the RADAR tool was used every time a patient had their observations taken with 87% of patients. Furthermore, 12 patients had an answer of 'yes' in response to one of the RADAR questions. However, 22 patients were diagnosed with delirium during their admission suggesting that RADAR did not aid in their diagnosis. In addition, of those with a 'yes' in response to RADAR question only 7 patients had a medical review following this. In addition, in only 14% of patients did RADAR correlate to the time at which a patient was diagnosed with delirium.
Conclusion
Our findings suggest that whilst RADAR can be an effective tool in screening for delirium, greater staff education and adherence to protocols was required. A significant proportion of patients diagnosed with delirium did not have a preceding positive RADAR screen, and when RADAR flagged concern medical review was often not triggered. We have conducted education within the department and will re -audit to evaluate the clinical response.
References:
- https://healthinnovationmanchester.com/wp-content/uploads/2018/10/Delirium-assessment-tool-RADAR.pdf
Comments
Interesting Result for Clinical Practice
Interesting outcome from the audit. RADAR is a tool used by multiple trusts/hospitals and it is interesting patients identified with delirium did not always score using the RADAR tool. It will be interesting to see the outcome of the re-audit to see how RADAR is improved and how education will hopefully lead to increased reviews of patient delirium status.
Evaluating the Effectiveness of the RADAR Tool in Delirium Detec
This audit highlights that while the RADAR tool is frequently completed, its potential to support delirium detection is not fully realised. Many cases were missed, and positive screens did not consistently trigger medical review. Strengthening staff education and reinforcing response protocols are key steps to improving timely recognition and management of delirium.