798 SPOT DELIRIUM - IMPROVING DELIRIUM AWARENESS AND ASSESSMENT USING ELECTRONIC 4AT

Abstract

Abstract Introduction Delirium is a common medical emergency which is associated with adverse outcomes but often unrecognised in up to two thirds of patients in the acute care setting. The 4AT is a sensitive and rapid assessment tool that can be applied to assess for delirium in clinical practice. Method An initial audit into the use of delirium diagnostic assessment scores on an Acute Medical Assessment Unit (AAU) was carried out. Medical notes were reviewed of patients over 75 years (n = 42) admitted over a 6 week period. A re-audit was undertaken following an educational induction session for junior doctors about delirium and 4AT (n = 42). Results Initially 14% of patients with documented acute confusion (n = 2) had a 4AT assessment completed. 2 patients were recognised to be at risk of delirium but did not have a 4AT. A diagnosis of dementia was documented for 28% (n = 12) of patients however only one had a 4AT. An educational session about delirium and how to complete the electronic 4AT assessment was organised for junior doctors on AAU. Before teaching, survey results showed no participants were familiar with the 4AT screening tool. Following the session all participants indicated knowing where to locate the electronic 4AT and reported improved confidence in recognising delirium. On re-audit 14 patients had documented confusion but 4AT assessment completion increased to 79%. For those identified as being at risk of delirium or having previous delirium 90% had a 4AT completed. All patients with a dementia had an AMTS and 89% also had a 4AT. Conclusion There was an improvement in documentation of both 4AT and AMTS forms following engagement in education and use of an electronic assessment tool to diagnose delirium. Future recommendations include interdisciplinary induction sessions to target a wider audience to improve awareness and recognition of delirium in acute care.