Delirium screening in hospices

About the project

Project title: Delirium screening practice in specialist palliative care units: a survey 
Hull York Medical School
Time frame: 2019: Completed
Contact for more details: Professor Miriam Johnson and Rebecca Woodhouse (University of York)
Publication: Paper published in BMC Supportive and Palliative Care

The aim of this study was to find out about how hospice staff identify delirium in hospices across the UK.

Of the 220 UK-wide hospice staff respondents (nurses 48%, doctors 31%, HCAs 10%) 68% screened for delirium only in response to clinical suspicion.

Routine screening was rare; on-admission (5%), during admission (6%). 48% used clinical judgement alone, or alongside a screening tool (14%) such as the 4 ‘A’s Test (4AT) or Confusion Assessment Method (CAM).

To diagnose delirium, 56% used clinical judgement only. A handful used DSM-5 (1%), or ICD-10 (1%).

62% of respondents had had delirium management training. 36% had hospice delirium guidelines. 59% said their hospice had no training about delirium screening.

Barriers to screening included: too many conditions to screen for, complexity of existing conditions, lack of guidance/training.

Screening facilitators included: screening tools, education/training, hospice guidelines.