evidence and practice
Improving the identification of patients with delirium using the 4AT assessment
Amelia Bearn Foundation doctor, York Teaching Hospital NHS Foundation Trust, York, England
William Lea Registrar, York Teaching Hospital NHS Foundation Trust, York, England
Jennie Kusznir Foundation doctor, York Teaching Hospital NHS Foundation Trust, York, England
Delirium is a common neuropsychiatric disorder that all those working with older people will have encountered at some stage. Delirium is often poorly identified in hospital settings and therefore not optimally managed. After data collection on the acute medical unit in an acute hospital trust in the UK it was evident that patients with signs of delirium were not being formally assessed and therefore not appropriately managed in many cases.
A quality improvement project introduced the 4AT delirium assessment tool to try to ensure that patients with delirium were being identified. The project team carried out several plan-do-study-act cycles to bring about our changes, which included a 4AT assessment sticker for nursing staff to complete and teaching for all healthcare staff. Through involvement of all members of the multidisciplinary team and ongoing feedback and changes we were able to increase assessment of delirium from 0% to 64%. There is ongoing work to be done to continue to improve delirium management, but by initially improving the assessment and identification of delirium we will make a difference to these patients’ outcomes.
Nursing Older People. doi: 10.7748/nop.2018.e1060Citation
Bearn A, Lea W, Kusznir J (2018) Improving the identification of patients with delirium using the 4AT assessment. Nursing Older People. doi: 10.7748/nop.2018.e1060Peer review
This article has been subject to external double-blind peer review and has been checked for plagiarism using automated softwareCorrespondence
Angela Keenan for design of delirium documentation and acute medical unit and AMB staff
Published online: 14 November 2018