Skip to main content

Advertisement

Log in

A survey of non-consultant hospital doctors’ perspectives, knowledge, and practices toward delirium in a large Irish hospital

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Delirium is a common condition in hospitals, particularly among older people. This refers to a dramatic decline in mental capabilities, which is marked by diminished concentration and consciousness.

Aim

The purpose of this study was to assess the views, knowledge, and behavior of non-consultant hospital doctors in managing delirium in a large Irish hospital.

Methods

Questionnaires were administered to 28 healthcare professionals from various departments according to Davis and MacLullich (Age Ageing 38(5):559–563, 2009). It was conducted between July and September 2023, with an emphasis on determining the prevalence rate, diagnostic criteria, and management strategies for delirium.

Results

The study established that the majority of respondents recognized the importance of delirium, but there appears to be a gap in the practical management of this clinical syndrome. Although many doctors agreed that delirium was significant, most lacked confidence in its diagnosis and management. The use of standardized assessment tools, such as the 4AT, was limited.

Conclusions

This study highlights the disparity between what is known and practiced by hospital doctors regarding delirium care. This implies increased training for delirium management with frequent use of assessment tools and ongoing education aimed at enhancing patient outcomes in cases of delirium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Singler K, Singler B, Heppner H (2011) Akute Verwirrtheit im Alter. Dtsch Med Wochenschr 136(14):681–684

    Article  CAS  PubMed  Google Scholar 

  2. Iglseder B, Frühwald T, Jagsch C (2022) Delirium in geriatric patients. Wien Med Wochenschr 172(5):114–121. https://doi.org/10.1007/s1035402100904z

    Article  PubMed  PubMed Central  Google Scholar 

  3. Oliveira J, e Silva L, Berning MJ et al (2021) Risk factors for delirium in older adults in the emergency department: a systematic review and meta-analysis. Ann Emerg Med 78(4):549–565

    Article  Google Scholar 

  4. Tran NN, Hoang TPN, Ho TKT (2021) Diagnosis and risk factors for delirium in elderly patients in the emergency rooms and intensive care unit of the National Geriatric Hospital Emergency Department: a cross-sectional observational study. Int J Gen Med 14:6505–6515

    Article  PubMed  PubMed Central  Google Scholar 

  5. Inouye SK, Charpentier PA (1996) Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 275(11):852–7. Available from: https://pubmed.ncbi.nlm.nih.gov/8596223/. Accessed 15 Oct 2023

  6. Maclullich A (2019) 4AT - rapid clinical test for delirium. 4AT - rapid clinical test for delirium. Available from: https://www.the4at.com/. Accessed 15 Oct 2023

  7. Bellelli G, Morandi A, Davis DHJ et al (2014) Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing 43(4):496–502. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24590568. Accessed 15 Oct 2023

  8. Tieges Z, MacLullich AMJ, Anand A et al (2020) Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age Ageing 50(3):afaa224. Available from: https://researchonline.gcu.ac.uk/en/publications/diagnostic-accuracy-of-the-4at-for-delirium-detection-in-older-ad. Accessed 16 Oct 2023

  9. Young J, Murthy L, Westby M et al (2010) Diagnosis, prevention, and management of delirium: summary of NICE guidance. BMJ 341(2):c3704. Available from: https://www.bmj.com/content/341/bmj.c3704. Accessed 17 Oct 2023

  10. Trogrlić Z, van der Jagt M, Bakker J et al (2015) A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes. Critical Care 19(1). https://pubmed.ncbi.nlm.nih.gov/25888230. https://doi.org/10.1186/s13054-015-0886-9

  11. Mansutti I, Saiani L, Palese A (2019) Detecting delirium in patients with acute stroke: a systematic review of test accuracy. BMC Neurology 19(1):310. Available from: https://pubmed.ncbi.nlm.nih.gov/31791260/

  12. Arachchi TMJ, Pinto V (2021) Understanding the barriers in delirium care in intensive care unit: a survey of knowledge, attitudes, and current practices among medical professionals working in intensive care units in teaching hospitals of Central Province, Sri Lanka. Indian Journal of Critical Care Medicine 25(12):1413–1420

    Article  PubMed  PubMed Central  Google Scholar 

  13. Davis D, MacLullich AM (2009) Understanding barriers to delirium care: a multicentre survey of knowledge and attitudes amongst UK junior doctors. Age Ageing 38(5):559–563. https://doi.org/10.1093/ageing/afp099

    Article  PubMed  Google Scholar 

  14. Jenkin R, Al-Attar A, Richardson S et al (2016) Increasing delirium skills at the front door: results from a repeated survey on delirium knowledge and attitudes. Age And Ageing 45(4):517–522. https://doi.org/10.1093/ageing/afw066

    Article  PubMed  PubMed Central  Google Scholar 

  15. Nwogbe OA, Haliso Y (2020) Continuing professional development assessment of healthcare professionals in public secondary hospitals in Lagos State, Nigeria. Information Impact: Journal of Information and Knowledge Management 11(1):26–39. https://doi.org/10.4314/iijikm.v11i1.3

    Article  Google Scholar 

  16. Siddiqi N, House AO, Holmes JD (2016) Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing 35(4):350–364

    Article  Google Scholar 

  17. Collins N, Blanchard M, Tookman A, Sampson EL (2009) Detection of delirium in the acute hospital. Age And Ageing 39(1):131–135. https://doi.org/10.1093/ageing/afp201

    Article  PubMed  Google Scholar 

  18. Grossmann F, Hasemann W, Graber A et al (2014) Screening, detection and management of delirium in the emergency department – a pilot study on the feasibility of a new algorithm for use in older emergency department patients: the modified confusion assessment method for the emergency department (mCAM-ED). Scand J Trauma Resusc Emerg Med 22(1). https://doi.org/10.1186/1757-7241-22-19

  19. Grover S, Kate N (2012) Assessment scales for delirium: a review. World J Psychiatry 2(4):58. https://doi.org/10.5498/wjp.v2.i4.58](10.5498/wjp.v2.i4.58

    Article  PubMed  PubMed Central  Google Scholar 

  20. Samuel A, Cervero RM, Durning SJ, Maggio LA (2021) Effect of continuing professional development on health professionals’ performance and patient outcomes: a scoping review of knowledge syntheses. Acad Med 96(6):913–923. https://doi.org/10.1097/acm.0000000000003899](10.1097/acm.0000000000003899

    Article  PubMed  Google Scholar 

  21. Buljac‐Samardžić M, Doekhie KD, Van Wijngaarden JDH (2020) Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health 18(1). https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-019-0411-3

  22. Kumar R, Haokip H, Tamanna, & Bairwa, M. (2022) Prevalence of delirium and predictors of longer intensive care unit stay: a prospective analysis of 207 mechanical ventilated patients. J Ment Health Hum Behav. https://doi.org/10.4103/jmhhb.jmhhb_228_21

    Article  Google Scholar 

  23. Bauernfreund Y, Butler M, Ragavan S, Sampson EL (2018) TIME to think about delirium: improving detection and management on the acute medical unit. BMJ Open Quality 7(3):e000200. https://doi.org/10.1136/bmjoq-2017-000200

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohamed Hassabo.

Ethics declarations

Ethical compliance

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards and it has been approved by the research and innovation office at St James’s hospital under reference number 8039.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hassabo, M., Mc Cluskey, P., Browne, J. et al. A survey of non-consultant hospital doctors’ perspectives, knowledge, and practices toward delirium in a large Irish hospital. Ir J Med Sci (2024). https://doi.org/10.1007/s11845-024-03661-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11845-024-03661-1

Keywords

Navigation