Improving delirium management through earily dection and proper documentation for continous care.

Delirium is an acute confusion that affects patients' mental function and behaviour, also affecting attention and awareness. In hospitalized patients, it reaches about 20% and can reach up to 60% in patients on palliative care.

Geriatric patients tend to have higher risk to develop delirium, which is also linked to increased hospital stay, falls, pressure ulcers, and death rates.

Common risk factors for delirium include pain, infection, decreased nutrition or dehydration, constipation, hypoxia, certain medications, and change in environment.

Despite its clinical importance and impact on patients, delirium tends to be poorly screened for and poorly documented. as Patients' baseline of mental functions are not known, it makes ongoing treatment within the hospital and in the community very challenging.

We have conducted two-cycle retrospective quality improvement project, which included 125 patients with risk factors of delirium in both cycles. Delirium documentation was assessed from the time patients came into the hospital and during the hospital stay until their discharge and communicating the finding to the GP. In the first cycle, 60% of patients who had risk factors for delirium were not screened for it. In the first cycle, 37 patients had risk factors for delirium were assessed, 14 did not have any risk factors and were assessed, and 74 were not assessed. In the second cycle, 55 had risk factors and were assessed, 27 didn't risk factors and were assessed, and 43 were not assessed. screening on the ward improved from 80.4% to 90.2%. Including findings on discharge letter to communicate issue with GP did not improve and remained at 17 cases in both cycles.

Summary:

With proper teaching and spreading awareness, delirium screening has improved slightly. Documentation on discharge letter remained poor. This highlights the need for continuous education and awareness among doctors to improve proper documentation of delirium to improve outcome, reduce complication, and length of stay in the hospital.