254 The use of delirium screening tools during acute inpatient hospital admissions: a local audit

Abstract

Abstract Background According to the ‘Second Irish National Audit of Dementia Care in Acute Hospitals (INAD-2), it is estimated that 20% of all adults admitted to hospital have a diagnosis of delirium during admission. Local HSE guidelines advise that all older adults (>65 years) should have a formalised delirium screening tool completed within the first 24 hours of presenting to the Emergency Department (ED). Methods We reviewed the medical admission documentation and subsequent medical notes in the charts of current inpatients on three Geriatric Medicine wards in the hospital. Data was collected from 56 patients over the age of 65 over a two day period. Results Data was collected from 56 patients. 21.4% (n = 12) had a delirium screening tool documented. Of those, 100% used 4AT testing and 100% were completed by the OPAL team (Older Person Assessment and Liaison Team)/ED Frailty Intervention Team. 5.4% (n = 3) met diagnostic criteria for delirium. 21.4% (n = 12) had delirium documented as a diagnosis on their medical admission, of which only 3 had delirium screening completed. 26.7% (n = 15) had a documented pre-existing diagnoses of dementia. Of those, 2 had a formal delirium screen documented. 25% (n = 14) were diagnosed with delirium later in their admission. Of those, 3 had a delirium screening tool completed at any point. The vocabulary used to describe delirium was also examined. Most commonly the words confusion (10) and agitated (4) were used instead of delirium. 4 had delirium subcategorised as hypoactive. Conclusion Delirium continues to be prevalent among our older inpatients and has been shown to be directly related to increased mortality. It is vital that we make use of the tools that are available to us to identify those at risk and those already suffering from this condition. We should prioritise appropriate delirium screening with standardised assessment tools in order to correctly identify those at risk.