Optimising sensory orientation measures for delirium prevention in older adult inpatients: an audit in Queen Elizabeth University Hospital

Introduction
NICE CG103 and SIGN 157 recommend non-pharmacological measures to reduce delirium risk, including visible clocks, day/date orientation, clear signage, and ensuring sensory aids are available and used. This audit assessed compliance with sensory orientation measures on an older adult delirium/dementia ward, then evaluated whether simple ward-based environmental and documentation prompts improved practice.

Methods
A baseline audit was performed on 14/04/26 on Ward 52, an older adult delirium/dementia ward at Queen Elizabeth University Hospital, Glasgow. Patients aged ≥65 years with documented cognitive impairment and/or delirium were included. A standardised proforma assessed bedside orientation, sensory aid documentation and availability, and completion of “Getting to Know Me” boards. Interventions included ward day/date/weather boards, addition of glasses/hearing aid prompts to bedside documentation, and staff encouragement to complete orientation boards. Re-audit was performed on 13/05/26 using the same proforma.

Results
At baseline, 19 patients were included; re-audit included 20. Accurate visible clocks improved from 89% to 95% (17/19 to 19/20), while accurate day/date orientation improved from 0% to 100% (0/19 to 20/20). Glasses documentation improved from 94% to 100% (16/17 to 20/20), and glasses availability among patients requiring them improved from 59% to 75% (10/17 to 6/8). Hearing aid documentation improved from 4/5 patients requiring hearing aids at baseline to 18/20 patients overall at re-audit. “Getting to Know Me” board completion remained similar, from 84% to 85% (16/19 to 17/20).

Conclusion
Simple environmental and documentation prompts improved compliance with key non-pharmacological delirium prevention measures on an older adult delirium/dementia ward, particularly day/date orientation and sensory aid documentation. Further PDSA cycles should focus on reliable bedside sensory aid availability through labelled storage, family involvement and routine checks.