By Ann Maree Keenan, Deputy CEO and Chief Nurse and Midwifery Officer, Safer Care Victoria.
Delirium is a hidden problem in our hospital system. We all see the impact of delirium, yet we have no idea what the true rate of delirium is.
Delirium is hiding on our wards, within the nursing notes describing ‘sundown syndrome,’ or in the agitation of an elderly person at night. It is hiding in our falls rates, in our pressure injury data and in our occupational violence statistics.
Delirium is often in plain sight, but we don’t recognise it or call it for what it is. It might be an elderly woman experiencing hallucinations, a gentleman slumped in a chair in a daze for hours at a time, or the pain of family members recognising that something about their loved one has ‘changed.’
Delirium causes undue stress, anxiety and pain, for the individual, their family and healthcare staff. It increases the risk of dementia, being discharged to high-care and death.
The sad thing is, despite the evidence about the impact of delirium and guidelines on management, it remains unrecognised, misdiagnosed and under-treated. We know that delirium is potentially preventable in one third of people at risk. Identifying it early and addressing the underlying causes is crucial to the prevention and management.
Until we know how common delirium is today, we won’t know if the strategies we develop to address delirium are working.
That’s why Safer Care Victoria is conducting a statewide point prevalence delirium survey in June. This Australian-first survey (and one of two worldwide) will measure the presence of potential delirium by assessing every, single person admitted to an acute Victorian public hospital bed. This will give us real, baseline data about the true impact of delirium across our state. We can then work with services to understand their rates and implement strategies to reduce avoidable delirium.
By conducting the point prevalence survey, we are raising awareness of delirium and bringing this hidden condition into the light. We want people to call delirium for what it is, to prevent, diagnose and manage delirium. Most of all, we want to prevent the impact of avoidable delirium on the people in our hospitals and their families.
You will see the in-house, trained delirium point prevalence surveyors across Victorian health services in June 2018. Please assist the surveyors as required as they undertake this worthwhile and ground-breaking study.
We look forward to sharing the results of this point prevalence survey later this year.
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