3856 Delirium—getting the basics right on a busy care of the elderly ward

Abstract Introduction Delirium is a disorder of attention and cognition that is commonly encountered on care of the Elderly wards. It is associated with a significantly increased risk of morbidity and mortality, both during and after hospital stays. Best practice guidance from NICE (National Institute for Health and Care Excellence) outlines standards for screening and preventing delirium. Where possible, appropriate preventative measures should be implemented to address underlying causes such as pain, hypoxia, constipation, and infection. However, when delirium occurs despite these measures, timely diagnosis and continued management of contributing factors are essential. Methods A single-cycle quality improvement project was conducted to assess the diagnosis and management of delirium in an inpatient geriatrics team. All patients aged 65 and over admitted during the assessment period (April 2025—June 2025) were included. Audits were carried out fortnightly before (n = 21) and after the intervention (n = 20), focusing on the use of the 4AT screening tool and the prescription of analgesia (regular or as required), oxygen, laxatives (where indicated) and electrolyte replacement/management plans. The intervention consisted of a ward-based education supported by a poster campaign. Results Following the intervention, there was a notable improvement in the prescription of laxatives (increasing from 57.1% to 84.6%), electrolyte replacement/management (from 81.0% to 100%), and oxygen prescription (from 36.3% to 61.5%). Prescription rates for analgesia remained consistently high (85.7 to 92.3%) both before and after the intervention. However, assessment for delirium using the 4AT tool declined post-intervention, with completion rates dropping from 38.1% to 15.4%. Conclusions Simple educational interventions can lead to improved implementation of preventative measures for delirium. However, screening for delirium remains suboptimal. In this population patients were normally admitted to our wards a few days after arrival into hospital—this was not routinely repeated. Further work is needed to integrate delirium screening more consistently into routine practice.