48HEALTHCARE PROFESSIONALS UNDERSTANDING OF DELIRIUM IN ACUTE CARE MEDICINE

Abstract

Background: Delirium is a serious neuropsychiatric disorder of increasing prevalence, with increased age, specifically over the age of 65, being a significant risk factor. Despite this it is missed by 53-87% of physicians in A&E. A 2013 study identified a prevalence gap in a London teaching hospital, with 9.2% of patients being misdiagnosed initially as not having delirium. Objective(s): The objective was to assess healthcare professionals (HCPs) knowledge and understanding of delirium within this hospital using a survey. Secondarily the trends were looked at between different subsets of HCPs using data collected. Design and Setting: Between March 2016 and May 2016, a survey was distributed amongst HCPs. The assessment took place after/in nurse handover meetings; nurse break rooms; organised FY1 junior doctor teaching; organised FY2 junior doctor teaching; grand rounds; surgical break rooms; and physical therapist's offices. Study Participants: A convenience sample of HCPs including 4 consultants, 56 junior doctors, 43 nurses, 17 physical therapists, 3 healthcare assistants and 1 occupational therapist. Result(s): Of 124 HCPs surveyed, 61.29% (76) had never heard of CAM-ICU, and 78.22% (97) had never heard of ICDSC, both validated screening tools for delirium. Over half of staff surveyed (56.45%) did not know whether there was a protocol for the management and treatment of delirium within their hospital. The top reason for not assessing delirium was having not been taught how to do the test. Of the different subsets of HCPs surveyed, based on the scoring system there was no significant difference between performance on questions apart from Group B (junior doctors) performing significantly better than all other groups on a question pertaining to the risk factors. Conclusion(s): There is poor understanding of delirium within the hospital, specifically knowledge of validated delirium screening tools, such as CAM-ICU, and knowledge of protocol and treatment options for delirium. It highlights a gap in educational provision by the hospital, a potentially easily remedied issue.