A patient at risk of delirium is offered a set of interventions to prevent delirium and regular monitoring for changes in behaviour, cognition and physical condition. Indicator 3a: Evidence of local arrangements for implementing interventions to prevent delirium for patients Definitional attributes activities for stimulating cognition non-drug measures to help Name: Evidence of local arrangements promote sleep for implementing interventions to prevent delirium for at-risk patients assistance for patients who usually wear hearing or Rationale: Delirium may be prevented in visual aids. more than one-third of patients.1 These interventions should be Multicomponent interventions tailored to individuals depending reduce the incidence of delirium and on the individual’s clinical risk may prevent complications, such as factors and the setting.3,4 The local falls.1 Regular monitoring of patients arrangements should provide for at risk of delirium for changes in tailored interventions. They must behaviour, cognition and physical include a process for documenting condition can assist the prompt the interventions and discussing detection of delirium.2 with the patient and/or their carer Collection and usage attributes the interventions being put in place. They must also include Computation: Documented evidence of local encouraging carers to be involved arrangements for implementing (e.g. providing orientation and interventions for patients reassurance to the patient). identified as being at risk of N/A developing delirium. Numerator: Interventions found to be effective Numerator N/A in preventing delirium that may criteria: be documented in the local Denominator: N/A protocol include:2,3 medication review Denominator criteria: N/A correction of dehydration/ malnutrition/constipation Setting: Hospital mobility activities Comments: This indicator has been sourced oxygen therapy from the Key principles for care of confused hospitalised older pain assessment persons5 and Delirium NICE and management Quality Standard 63.6 regular reorientation and reassurance
A patient at risk of delirium is offered a set of interventions to prevent delirium and regular monitoring for changes in behaviour, cognition and physical condition. Indicator 3a: Evidence of local arrangements for implementing interventions to prevent delirium for patients Definitional attributes Name: Evidence of local arrangements for implementing interventions to prevent delirium for at-risk patients Rationale: Delirium may be prevented in more than one-third of patients.1 Multicomponent interventions reduce the incidence of delirium and may prevent complications, such as falls.1 Regular monitoring of patients at risk of delirium for changes in behaviour, cognition and physical condition can assist the prompt detection of delirium.2 Collection and usage attributes Computation: Documented evidence of local arrangements for implementing interventions for patients identified as being at risk of developing delirium. Interventions found to be effective in preventing delirium that may be documented in the local protocol include:2,3 medication review correction of dehydration/ malnutrition/constipation mobility activities oxygen therapy pain assessment and management regular reorientation and reassurance activities for stimulating cognition non-drug measures to help promote sleep assistance for patients who usually wear hearing or visual aids. These interventions should be tailored to individuals depending on the individual’s clinical risk factors and the setting.3,4 The local arrangements should provide for tailored interventions. They must include a process for documenting the interventions and discussing with the patient and/or their carer the interventions being put in place. They must also include encouraging carers to be involved (e.g. providing orientation and reassurance to the patient). Numerator: N/A Numerator criteria: N/A Denominator: N/A Denominator criteria: N/A Setting: Hospital Comments: This indicator has been sourced from the Key principles for care of confused hospitalised older persons5 and Delirium NICE Quality Standard 63.6
Delirium-CCS-Indicators-WORD.docx