Britain’s National Institute for Health and Clinical Excellence (NICE) developed 13 specific recommendations that address the care and interventions for persons at risk for delirium.

-Team@CMHF

• The guideline development team was led by Rachel O’Mahony, PhD, with the National Clinical Guideline Centre, the Royal College of Physicians, in London, United Kingdom.
• According to Dr O’Mahony and colleagues, although delirium is common, particularly in patients who are hospitalized after surgery and in illnesses developing over a short period, delirium is often under-recognized and under-diagnosed.
• They also estimate that delirium, when present, increases medical costs by an additional $2500 per patient (based on 2004 Medicare data).
• The current recommendations from NICE focus on the prevention and management of delirium.
• The recommendations focus on patient-centered interventions tailored to the person’s individual needs in a given setting.
• The involvement of a multidisciplinary healthcare team is emphasized.
• The patient is also monitored and treated for clinical symptoms and signs such as dehydration, constipation, lack of oxygen, and infection.
• The recommendations indicate that patients also be supported through the treatment of pain and co-morbidities as well as provided with adequate nutrition, sleep support, relief of sensory impairment, and strategies to overcome immobility.
• The key components of the multi-component intervention package may not seem challenging they may even be considered basic care.
• However, the challenge for delirium prevention is one of high fidelity
• Some of these components are provided to some of the patients some of the time, but prevention of delirium requires that we do all of these things all the time to all of the patients who are at risk.

For further reading log on to
http://www.medscape.com/viewarticle/744705