Practice question

How do I improve delirium care for older surgical patients?

A serious condition with poor outcomes, delirium is best prevented by early identification and treatment

Delirium is categorised by a sudden onset of fluctuating altered consciousness with changes to perception and cognitive function. It is a serious condition, associated with poor outcomes, but can be prevented and managed effectively with early assessment, identification, simple interventions and early treatment (Partridge et al 2017).

Delirium is common and seen in most hospital settings where older patients receive care. The surgical environment is no different and, while the surgical episode itself can be a potential trigger, many of the risk factors seen in the older medical and surgical population are the same.


When managing delirium, prevention is more effective than cure, so assessments must be tailored to highlight patients with predisposing factors (Table 1). In the surgical setting, this should be done early in the preoperative


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