Management of delirium on acute geriatric wards: A survey in Belgian hospitals

Background: Delirium often occurs among hospitalized older patients and is associated with high rates of mortality and morbidity, institutionalization and increased length of stay. Despite its clinical importance, delirium is frequently not recognized and poorly managed in acute care settings. A clear policy or guideline can be of help in the early detection and management of patients with delirium. Objectives: Gain insight into the existence and use of structured delirium management protocols on geriatric wards of Belgian hospitals. Methods: This study involved 110 hospitals with an acute geriatric ward. A questionnaire was developed by a multidisciplinary panel of experts (geriatricians and nurses) and sent to the medical head of the geriatric department. The response rate was 59.1%. Results: Only one quarter (n = 17; 26.2%) of the Belgian hospitals have a written delirium policy at the geriatric department level. At hospital level, the presence of a policy is even less frequent (n = 10; 15.4%). Although the majority (n = 36; 72%) state to have an oral or written arrangement for delirium prevention, only few have a written protocol to identify the cause (n = 10; 15.4%) and to manage (n = 9; 13.8%) delirium. Furthermore, only 22.6% (n = 14.5) have an information leaflet available for patients and/or family. Conclusion: Given the high rates and complexity of delirium management in geriatric wards, hospitals need to further implement evidence-based prevention, screening and standard intervention care plans to maintain uniformity and quality of care in delirium management. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.