An Audit of Time to Inpatient Bed In Patients With A Suspected Delirium

Abstract

Abstract Background Our local Dementia/Delirium Combined Pathway and Care Bundle for Emergency Department (ED) and Acute Medical Assessment Unit sets a target door to ward admission in patients aged over 65 years with a suspected delirium at less than 6 hours. This audit assessed if this target is being met in patients with a suspected delirium. Methods Retrospective point prevalence audit of 240 randomly selected patients who were assessed by the Frailty Intervention Team (FIT) in the Mater Misericordiae University Hospital ED in 2022, aged ≥ 65 years with a suspected delirium (4AT ≥4) and no delirium (4AT=0). Time of presentation to ED, time of admission to ward bed, ward name and length of hospital stay were recorded. Results The median age in patient's with a 4AT ≥4 was 86 years (range 65-99). There was an equal spread across gender groups in patient's with a 4AT ≥4; 55.3% (n=52) females and 44.7% (n=42) male. The median wait time in ED for patients with a 4AT ≥4 was 25.26 hours (range 6.75-83.73) vs 21.65 hours (range 5.98-50.53) in patients with a 4AT=0. Only 19% (n=18) of patients with a 4AT ≥4 were admitted to a Specialist Geriatric Ward. The mean length of stay in patients with a 4AT ≥4 was 28.457 days vs 14.132 days in those with a 4AT=0 (p value=0.002, Mann-Whitney U test). Conclusion Older adults with a delirium spend prolonged periods of time in the ED. We are not meeting our local target of 6 hours from ED presentation to ward bed. Length of hospital stay is prolonged in patients with delirium. Our aim is to create a dedicated delirium bed on our Geriatric Specialty Ward so that we can provide delirium specific care and reduce overall length of hospital stay.