'Sense Check': Improving Sensory Optimisation to Reduce Delirium Risk in Elderly Inpatients

Introduction 

Delirium affects 20–30% of elderly inpatients and is associated with increased morbidity, mortality and hospital stay. NICE CG103 and the Royal College of Physicians identify visual and hearing impairment as modifiable risk factors of delirium. Routine assessment and optimisation of sensory aids are recommended yet clinical compliance varies. Aims were to assess current practice regarding the accessibility and documentation of vision / hearing aids in elderly inpatients. Our quality improvement goal was to improve compliance with sensory assessment to greater than 80%.

Methods

A baseline audit was conducted across elderly care wards at Good Hope Hospital. Data was collected between 5 January-18 February 2026 (n=112) and gathered through bedside assessment / electronic records. A ‘Sense Check’ initiative was introduced as an intervention, including teaching to doctors. Following this, a second cycle of data collection occurred between 28th February-30th March 2026 (n=120). Further interventions involved ‘tea trolley teaching’ to nurses/AHPs, resulting in a third cycle of data collection occurring 24th August-4th September 2026 (n=94).

Results

Accessibility of sensory aids were below the 80% standard. At baseline, 67.5% of patients had glasses accessible at the bedside and 60.9% of patients had accessible and functional hearing aids. Cycle 3 revealed 64.7% of patients had glasses accessible and 29.4% had hearing aids accessible. Sensory assessment was not routinely recorded on admission / ward rounds and sensory optimisation was rarely included in documented delirium prevention plans. There was no standardised clerking / ward-round checklist to assess and document sensory impairment.

Conclusion

Sensory optimisation remains an under-recognised, modifiable risk factor for delirium. Our audit identified significant gaps in accessibility and documentation of glasses / hearing aids. To encourage compliance of routine sensory assessment, low-cost visual icons can be displayed at the bedside for timely awareness of sensory needs and improving patient safety.