Detected Delirium Prevalence and Practices in Australia and New Zealand: A Sub‐Analysis of the World Delirium Awareness Day Prevalence Study

OBJECTIVES: To describe detected delirium prevalence and current delirium-related practices in Australian and New Zealand healthcare sites. METHODS: This study was a sub-analysis of Australian and New Zealand data from an international cross-sectional survey conducted on World Delirium Awareness Day 2023. Delirium was identified using existing clinical practices on participating wards. RESULTS: Across 257 wards of varying specialties and acuities, detected delirium prevalence was 16% (n = 637/4033) at 8:00 AM and 16% (n = 609/3836) at 8:00 PM. Delirium assessment rates were 63% (n = 4033/6369) at 8:00 AM and 63% (n = 3836/6091) at 8:00 PM. Most wards (93%) used validated assessment tools, most commonly 4AT and CAM. Just over half (53%) assessed for delirium at least daily, whereas 37% only assessed in response to the sudden changes in consciousness or clinical condition. Written delirium protocols were common (91%). Non-pharmacological strategies were widely implemented, particularly ensuring adequate fluids (87%), mobilisation (84%) and pain management (84%). Frequent use of pharmacological interventions was often reported, particularly antipsychotics, including risperidone (36%), haloperidol (35%) and quetiapine (31%). Key perceived barriers to implementation of evidence-based delirium care were staff shortage (70%), lack of time to educate and train staff (53%) and missing knowledge (49%). CONCLUSIONS: In Australia and New Zealand, delirium assessment practices have improved over time. Non-pharmacological strategies are widely used; however, antipsychotic use remains substantial. Workforce constraints, education gaps and system pressures may contribute to variability in delirium care delivery. Addressing these factors, alongside engagement with carers, may support further improvements in care. Ongoing surveillance through repeated surveys would help monitor trends in delirium care over time.

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Journal
Australasian Journal on Ageing
Published
2026-08-27
DOI
https://doi.org/10.1111/ajag.70227
Primary Topic
Intensive Care Unit Cognitive Disorders
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article
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article

Detected Delirium Prevalence and Practices in Australia and New Zealand: A Sub‐Analysis of the World Delirium Awareness Day Prevalence Study

Aik Haw Tan, Christina Aggar, Gideon A. Caplan, Heidi Lindroth et al.
Australasian Journal on Ageing
Intensive Care Unit Cognitive Disorders
article

Detected Delirium Prevalence and Practices in Australia and New Zealand: A Sub‐Analysis of the World Delirium Awareness Day Prevalence Study

Aik Haw Tan, Christina Aggar, Gideon A. Caplan, Heidi Lindroth, Jane Hopkins, Kristel Ward‐Stockham, Frederick Sundram, Stephanie Tam, Peter Nydahl, Valerie Ozorio, Robert Welschinger, Kasia Bail, Keibun Liu, S. Kohler, Yu-Min Lin, John Hopkins, Engelina Groenewald, Kate Sainsbury, Shiny Huang, Sharon Liefrink, Elizabeth Cusworth, Mercy Wanyika, Elaine Newman, Joventino Tongco, Melinda Webb‐St Mart, Marleta Fong, Renae Nicol, Elaine Docherty
article en

Abstract

OBJECTIVES: To describe detected delirium prevalence and current delirium-related practices in Australian and New Zealand healthcare sites. METHODS: This study was a sub-analysis of Australian and New Zealand data from an international cross-sectional survey conducted on World Delirium Awareness Day 2023. Delirium was identified using existing clinical practices on participating wards. RESULTS: Across 257 wards of varying specialties and acuities, detected delirium prevalence was 16% (n = 637/4033) at 8:00 AM and 16% (n = 609/3836) at 8:00 PM. Delirium assessment rates were 63% (n = 4033/6369) at 8:00 AM and 63% (n = 3836/6091) at 8:00 PM. Most wards (93%) used validated assessment tools, most commonly 4AT and CAM. Just over half (53%) assessed for delirium at least daily, whereas 37% only assessed in response to the sudden changes in consciousness or clinical condition. Written delirium protocols were common (91%). Non-pharmacological strategies were widely implemented, particularly ensuring adequate fluids (87%), mobilisation (84%) and pain management (84%). Frequent use of pharmacological interventions was often reported, particularly antipsychotics, including risperidone (36%), haloperidol (35%) and quetiapine (31%). Key perceived barriers to implementation of evidence-based delirium care were staff shortage (70%), lack of time to educate and train staff (53%) and missing knowledge (49%). CONCLUSIONS: In Australia and New Zealand, delirium assessment practices have improved over time. Non-pharmacological strategies are widely used; however, antipsychotic use remains substantial. Workforce constraints, education gaps and system pressures may contribute to variability in delirium care delivery. Addressing these factors, alongside engagement with carers, may support further improvements in care. Ongoing surveillance through repeated surveys would help monitor trends in delirium care over time.

Australasian Journal on AgeingVol. 45(3)
Regenstrief Institute (US), Mayo Clinic (US), University of Auckland (NZ), The University of Queensland (AU), University of Canberra (AU), Paracelsus Medical University (AT), Sydney Adventist Hospital (AU), Fiona Stanley Hospital (AU), Auckland City Hospital (NZ), Frankston Hospital (AU), Sir Charles Gairdner Hospital (AU), UNSW Sydney (AU), Department of the Premier and Cabinet (AU), Eastern Health (AU), Waitemata District Health Board (NZ), Women's and Children's Health Network (AU), Palmerston North Hospital (NZ), Prince of Wales Hospital (AU), University Hospital Schleswig-Holstein (DE), Counties Manukau District Health Board (NZ), Northern Sydney Local Health District (AU), Peninsula Health (AU), Mayo Clinic in Arizona (US), Prince Charles Hospital (AU), Mayo Clinic in Florida (US), Austin Health (AU), Act Health (AU), Indiana University – Purdue University Indianapolis (US), Southern Cross University (AU), University of Lübeck (DE)
Openalex Percentile: Top 9%
Intensive Care Unit Cognitive Disorders
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