Background Delirium is a serious and distressing condition which commonly affects people with life-limiting illness. Around one-third of those admitted to hospices have delirium, and many more experience delirium in the last days of life (Watt, Momoli, Ansari, et al. Palliat Med. 2019;33(8):865–77). We sought to implement a range of initiatives to improve delirium care in two hospice inpatient units. To inform this work we designed a questionnaire to examine staff confidence regarding delirium care and identify areas for improvement.

Aim To investigate staff knowledge, confidence, and training needs regarding the care of terminally ill patients with delirium in two hospice inpatient units.

Method Drawing on previous literature we developed a questionnaire consisting of closed and free-text questions, administered online. Nurses, doctors, health care assistants and allied health professionals were eligible to participate. Ethical approval was obtained from the University of Edinburgh Clinical Psychology Research Ethics Committee.

Results In total 45 participants were recruited (Site A = 22, Site B = 23). These were nurses (n=20), doctors (n=10), health care assistants (n=10) and allied health professionals (n=5). About half (53%) correctly identified the prevalence of delirium on admission to an inpatient unit, and 38% correctly identified prevalence in the last days and hours of life. Nearly all participants correctly identified delirium risk factors and causes. However, approximately one third reported some uncertainty regarding delirium management. Delirium detection tools were routinely used by one third of doctors and nurses, with Site B staff more likely to use a validated tool compared with Site A. The 4AT was most used. Less than half (41%) agreed that they had received adequate training in delirium care, and nearly all agreed that future training on delirium detection, prevention and management would be useful.

Conclusion Further training and the development of resources to support staff to provide excellent delirium care in hospice inpatient units is recommended.