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Audit of the use of a screening tool to improve recognition of delirium in a palliative care unit
  1. L M Cogdell1 and
  2. C Lunt2
  1. 1Roxburghe House, Aberdeen, UK
  2. 2Aberdeen Royal Infirmary, Aberdeen, UK

Abstract

Introduction The British Geriatric Society recommends that all older patients admitted to hospital are screened for delirium using a tool such as the abbreviated mental test (AMT). No similar guidelines specifically for palliative patients exist. However delirium is very common in patients in specialist palliative care units (SPCU). Delirium remains under diagnosed and is associated with a poor prognosis. It is often reversible if recognised early and the cause identified and treated promptly. A previously undertaken audit showed that no screening tool for delirium was currently used in our SPCU despite high prevalence of delirium. The action plan recommended the introduction of routine screening.

Aim To audit the use of AMT in patients admitted to SPCU.

Methods Following previous audit junior doctors were asked to perform an AMT on every new admission. Education and labels listing the 10 AMT questions to stick in notes were provided. Case note review for 20 SPCU in-patients was performed on 1 day 4 months after the introduction of screening tool.

Results 70% of patients had an AMT performed on admission. The patients who did not have an AMT done were mainly in the terminal phase of their illness. 43% of patients who had an AMT performed scored less than 8 suggesting that they have a high chance of delirium.

Conclusion The introduction of the screening tool has improved the number of newly admitted patient's being assessed for delirium.

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