Implementing Standardised Delirium Screening Using the Four A's Test (4AT) in the Emergency Department: A Quality Improvement Project

An improvement in 4AT usage was demonstrated compared to baseline with the most effective intervention being formal teaching; however, the target of 80% was not met. There are notable barriers to the implementation including rotational training and challenging working conditions. This highlights the need for robust quality improvement and systemic level change with consideration given to to implementation of 4AT during nurse triage, perhaps utilising formal teaching.