Improving Delirium Awareness and Screening

The 4AT Score is a simple tool recommended by NICE to help detect Delirium in everyday practice. In QEH Gateshead, clerking sheets include this score however it is frequently missed by admission doctors.
Our QIP standard was that all patients >65 should be screened for Delirium in accordance with NICE Guidance and to improve this. Clerking sheets were audited to assess completion of 4AT scores.
Improvement Methodology included prompt cards on working computers, posters in handover rooms, verbal reminders and quick teaching after morning handover.
Run charts shows improvement in patients >65 screened for Delirium in both wards with non-random pattern / signal of change after interventions with too few runs, or crossings of the median line according to statistical table.
Our QIP highlights that posters and prompt cards are helpful tools that can aid as reminders, however may cause cluttering of workspace.
Next steps include further cycles without interventions to assess for compliance.
If targets are still not met we could consider liaising with IT department regarding incorporating checkbox on electronic patient system.