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Screening for Delirium: A survey of delirium screening practice in specialist palliative care units in the UK

Woodhouse, Rebecca; Siddiqi, Najma; Boland, Jason W; Featherstone, Imogen; Johnson, Miriam J

Authors

Rebecca Woodhouse

Najma Siddiqi

Jason W Boland

Imogen Featherstone



Abstract

Objectives
Delirium is common and distressing in palliative care settings. This survey aims to describe current practice regarding delirium identification in specialist palliative care units (SPCUs), such as inpatient hospices, in the UK.
Methods
An 18-item anonymous online survey was distributed by Hospice UK to their network of clinical leads (n=223), and to their research mailing list (n=228). The survey was also sent to the chair of the Hospice UK executive clinical leads forum for direct dissemination to forum representatives (n=20). Clinical leads and forum representatives were asked to distribute the survey to healthcare staff in their SPCUs.
Results
220 SPCU staff (48% nurses; 31% doctors; 10% healthcare assistants) completed the survey. Approximately half reported using clinical judgement alone to screen (97/204; 48%) and/or diagnose (124/220;56%) delirium. Over a third used an assessment tool to screen for delirium (78/204;38%). The majority (150/220;68%) reported screening in response to clinical symptoms, while few reported routine on-admission (11/220;5%) or daily-during admission (12/220;6%) screening. Most respondents had received some training on delirium (137/220; 62%). However, 130/220 (59%) said their SPCU did not have a training program for delirium screening and only 79/220 (36%) reported that their SPCU had delirium clinical guidelines. The main barriers to routine screening included: lack of delirium training, lack of guidelines and complexity of patient’s conditions.
Conclusion
There is variation in practice for delirium screening and diagnosis in SPCUs. Clinical guidelines for delirium, including consensus on which screening tools to use, are needed for this setting.

Citation

Woodhouse, R., Siddiqi, N., Boland, J. W., Featherstone, I., & Johnson, M. J. (in press). Screening for Delirium: A survey of delirium screening practice in specialist palliative care units in the UK. BMJ supportive & palliative care, https://doi.org/10.1136/bmjspcare-2020-002251

Journal Article Type Article
Acceptance Date Apr 27, 2020
Online Publication Date May 15, 2020
Deposit Date Apr 28, 2020
Publicly Available Date May 15, 2020
Journal BMJ supportive & palliative care
Print ISSN 2045-435X
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1136/bmjspcare-2020-002251
Public URL https://hull-repository.worktribe.com/output/3501552
Publisher URL https://spcare.bmj.com/content/early/2020/05/15/bmjspcare-2020-002251

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Article (167 Kb)
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Publisher Licence URL
http://creativecommons.org/licenses/by-nc/3.0

Copyright Statement
©2020 University of Hull





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