Section Five

Multidisciplinary Delirium Care

Approx Time To Complete: 30 Mins

Interdisciplinary Teamwork

Multidisciplinary delirium care is a collaborative approach involving healthcare professionals working together to provide comprehensive support to individuals experiencing delirium.  For example, the process may begin with a nurse recognising the initial symptoms of delirium, leading to doctors diagnosing the condition and creating a tailored treatment plan.  Pharmacists will then play a vital role in managing medications, adjusting, and prescribing alternatives specific to delirium management. 

Occupational therapists can also contribute significantly to discharge planning, ensuring a smooth transition for individuals affected by delirium.  Social workers, dietitians, and other professionals may also be involved, forming a cohesive team to address the unique challenges posed by delirium.  The effective care of individuals with delirium relies on seamless teamwork in preventing, assessing, and managing this acute confusional state.  When each professional brings their expertise to the table, the patient is more likely to receive holistic care.

As you’ve read, this e-resource has been co-designed to help health professions students understand delirium.  It has also been developed to emphasise the importance of collaborative work.  In the following section, students from Queen’s University Belfast and the University of Limerick will explore the roles of the healthcare professional team in the journey of a person living with delirium.  This video aims to provide an insightful overview of how delirium is recognised, assessed, managed, and prevented, highlighting the crucial roles of team members in delivering comprehensive care.

Student Delirium Video About Nursing Home Resident Jane

Watch this student-led video about resident, Jane.

The video about multidisciplinary delirium care highlighted the patient journey.  In addition to working together in the direct care of a patient, multidisciplinary teams can also work together to optimise future care in delirium.  For example, the use of Quality Improvement (QI) methodology is one way to enable healthcare professionals to work together to develop ideas to enhance prevention, assessment and management of delirium.

Quality improvement (QI) in healthcare is a systematic approach to enhance patient outcomes, streamline processes, and optimize the overall delivery of care.  It is crucial in healthcare settings to address evolving patient needs, stay current with evidence-based practices, and foster continuous learning.  In delirium care, QI is particularly valuable as it allows healthcare teams to focus on preventive measures, identifying and implementing strategies to reduce the incidence and impact of delirium.  The Plan-Do-Study-Act (PDSA) cycle is a fundamental QI methodology.  

Sourced From Demin.org
Delirium Poster by Students

It involves planning a change, implementing it, observing the results, and then adjusting the approach based on those observations.  For a delirium QI project, a collaborative effort could entail the following: The doctor may lead the team in establishing evidence-based delirium prevention protocols.  Nurses can implement these protocols in daily patient care, incorporating regular screenings and proactive interventions.  

Pharmacists play a vital role in medication review and optimisation to mitigate delirium risk.  The PDSA cycle would then involve iterative adjustments to these preventive strategies based on real-time feedback and outcomes.  This dynamic and inclusive approach ensures that all team members contribute to refining and implementing strategies for effective delirium prevention.  For example, please click on the poster below to review how three nursing students helped to develop a staff-poster to raise awareness about delirium in their hospital placement. 

QI Ideas
Click the arrow to the right to review some possible QI ideas that you could implement in the future.
1. Standardised Delirium Screening Protocol
Implement a standardised delirium screening protocol across hospital, community, and nursing home settings. Outcome: Increase in timely recognition of delirium cases, leading to early intervention and improved patient outcomes.
2. Multidisciplinary Training Program
Develop and implement a comprehensive training program for healthcare professionals on delirium prevention and management. Outcome: Enhanced knowledge and skills among the healthcare team, resulting in improved care delivery and reduced delirium incidence.
3. Medication Review and Optimisation
Establish a regular medication review process involving pharmacists, nurses, and doctors to optimise prescriptions, reducing medications that contribute to delirium risk. Outcome: Decreased incidence of drug-induced delirium and improved overall patient safety.
4. Patient and Family Education
Create educational materials for patients and their families about delirium, its risk factors, and preventive measures. Outcome: Increased awareness and involvement of families in delirium prevention, fostering a collaborative approach to care.
5. Fall Prevention Strategies
Implement targeted fall prevention strategies, including environmental modifications and patient-specific interventions, to reduce falls associated with delirium. Outcome: Reduction in fall-related injuries and complications in delirious patients.
6. Communication Enhancement
Develop a standardised communication system among healthcare professionals to facilitate information exchange about delirium cases during patient transitions across different care settings. Outcome: Improved continuity of care, reducing the risk of overlooked delirium episodes.
7. Monitoring and Reporting System
Establish a robust monitoring and reporting system for delirium cases, ensuring prompt feedback and continuous improvement. Outcome: Enhanced data-driven decision-making, leading to more effective delirium care strategies.
8. Environmental Modifications
Conduct regular assessments of physical environments in care settings to identify and address factors contributing to delirium, such as noise reduction and improved lighting. Outcome: Improved environmental conditions, reducing triggers for delirium.
9. Early Rehabilitation Programs
Introduce early rehabilitation programs involving physical and occupational therapy for delirium patients to mitigate the functional decline associated with prolonged bed rest. Outcome: Improved mobility and functional outcomes in patients recovering from delirium.
10. Care Coordination Meetings:
Establish regular care coordination meetings involving healthcare professionals from different disciplines to discuss complex delirium cases and develop tailored care plans. Outcome: Enhanced collaboration, resulting in more comprehensive and individualised delirium care.
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Dr Margaret Graham Discusses Person-Centred Care

Watch this video from Dr Margaret Graham in which she discusses person-centred care in relation to delirium.

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