Delirium
At Sunnybrook, we are working together to protect our most vulnerable patients by preventing, recognizing and managing the effects of delirium.
What is delirium?
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Delirium:
- Disturbance in consciousness with reduced ability to focus, sustain, or shift attention
- Change in memory, language or orientation, or development ofa perceptual disturbance not explained bya pre-existing, established, or evolving dementia
- Disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the day
- Caused by direct physiological consequences of a general medical condition
Delirium by the numbers:
- 12-51% post-operative
- 19-82% intensive care
- 20-56% nursing home
- 47% palliative care
- 27% stroke units
- 8-17% emergency room
Risks
Delirium increases:
- odds of dying in hospital by 2-4X
- odds of dying within 6 months by 2.5-5X
- length of hospital stay by 2X
- risk of being re-admitted to the hospital by 2X
- rates of cognitive decline and dementia up to 41X
Delirium is expensive:
- it costs one Toronto hospital an estimated $17 million dollars a year from 'increased length of stay' alone
Delirium can be prevented:
- 30-40% of delirium cases can be prevented
Using the CHASM care plan for the prevention and management of delirium, a series of interventions in the following areas:
C - Cognition and perception
H - Hydration
A - Agitation
S - Sleep-wake cycle
M - Mobility
Brought to you by the:
Perioperative Brain Health Centre at Sunnybrook
What we're doing at Sunnybrook »
The Sunnybrook Senior Friendly Strategy is leading the way through quality improvement initiatives that enhance education and awareness about delirium. Through a shared vision for enhancing the care of all older adults at Sunnybrook, these initiatives target many areas across the continuum of care — from the emergency department, to intensive care, to the acute care units.
As part of the Quality Improvement Plan, we are working collaboratively with front line staff to develop the knowledge, skills and judgment needed to achieve this strategic priority.
World Delirium Awareness Day
In recognition of World Delirium Awareness Day, all are invited to attend an educational event at Sunnybrook to learn, educate, share and network together!
Sunnybrook's Second World Delirium Awareness Day:
- Wednesday, March 13, 2019:
- 11:30am to 12pm - networking
- 12pm to 1pm - presentations
- Location: McLaughlin Auditorium, EG 18a, Bayview Campus (2075 Bayview Avenue)
- Presentations:
- Featured guests: Toronto Paramedic Services will share experience from the field in interacting with patients potentially at risk of delirium
- 'Effective Communication Strategies with Delirium Care' - presented by Stephanie Horner, OT
- 'Quietly Delirious: A look at hypoactive delirium' - presented by the Nursing Council priority working group
For more info on World Delirium Awareness Day, visit idelirium.org
Read more from Sunnybrook:
- Senior Friendly Toolkit - resources for healthcare providers
- Preventing delirium in the hospital
- Why are elderly patients at risk of delirium in the ER?
- Explaining delirium: Why patients may become confused during recovery
- Does surgery cause or worsen dementia?
- Researchers explore using video games as a way to reduce delirium in seniors
- Making strides in health-care approaches for seniors
- Today’s role of the anesthesiologist goes far beyond the operating room
- How anesthesia affects the brain
- The nurse practitioner, Deborah Brown