What delirium detection tools are used in routine clinical practice in the United Kingdom? Survey results from 91% of acute healthcare organisations

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Abstract

Purpose
Our aim was to collect information on delirium assessment processes and pathways in non-intensive care settings in the United Kingdom (UK).

Methods
We sent a Freedom of Information request to 169 UK National Health Service (NHS) hospitals, trusts and health boards (units) in July 2020 to obtain data on usage of delirium assessment tools in clinical practice and delirium pathways or guidelines.

Results
We received responses from 154/169 units (91% response rate). Of these, 146/154 (95%) units reported use of formal delirium assessment processes and 131/154 (85%) units had guidelines or pathways in place. The 4 'A's Test (4AT) was the most widely used tool, with 117/146 (80%) units reporting use. The Confusion Assessment Method was used in 65/146 (45%) units, and the Single Question to identify Delirium (SQiD) in 52/146 (36%) units.

Conclusions
Our findings show that the 4AT is the most commonly used tool in the UK, with 80% of units reporting use. This study adds to our knowledge of real-world uptake of delirium detection methods at scale. Future studies should evaluate real-world implementation of delirium assessment tools further via (i) tool completion rates and (ii) rates of positive scores against the expected prevalence delirium in the clinical population concerned.

Keywords: Delirium, Freedom of Information, 4AT, Confusion assessment method (CAM), hospital.
Original languageEnglish
JournalEuropean geriatric medicine
Early online date18 May 2021
DOIs
Publication statusE-pub ahead of print - 18 May 2021

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