Delirium Clinical Care Standard

This clinical care standard aims to improve the prevention of delirium in patients at risk – and the early diagnosis and treatment of patients with delirium.

Delirium is an acute change in mental status that is often triggered by acute illness, surgery, injuries or adverse effects of medicines. Despite being a serious condition that is associated with increased mortality, delirium has been poorly recognised in Australian hospitals and internationally.

Launch of updated Delirium Clinical Care Standard, 2021

The updated Delirium Clinical Care Standard was launched at the Australasian Delirium Association Conference, DECLARED 2021, on Thursday 9 September 2021, by Associate Professor Gideon Caplan, President of the Australasian Delirium Association.

Watch the recording of Professor Caplan's talk below.

Also available are presentations from Professor Susan Kurrle, geriatrician and Curran Chair in Health Care of Older People, University of Sydney and Anne Cumming, Principal Advisor, Cognitive Impairment from the Commission, who discussed what's new in the updated Delirium Clinical Care Standard and what it means in practice.

View the presentations

2021
Publication, report or update

Contents of the standard and resources

The Delirium Clinical Care Standard is made up of eight quality statements and a set of indicators for safe and appropriate care.

Background

About 10–18% of Australians aged 65 years or older have delirium at the time of admission to hospital, and a further 2–8% develop delirium during their hospital stay. 

Delirium is more common among older patients, but it also occurs in other age groups. Prevalence is higher in critical care and hospital palliative care settings, and rates in residential aged care services exceed those in the general community.

Prevention is the most effective strategy, but early intervention can also improve outcomes for patients with delirium.

This clinical care standard has been widely implemented in Australian hospitals since it was first released in 2016. The standard builds on other work undertaken by the Commission, such as the cognitive impairment program and the A Better Way to Care resources. In 2019–20, the rate of delirium as a hospital-acquired complication was 35.7 per 10,000 admissions.

The NSQHS Comprehensive Care Standard, Action 5.29 requires health service organisations to incorporate best-practice strategies for the early recognition, prevention, treatment and management of cognitive impairment in their systems of care, including the Delirium Clinical Care Standard.

Consultation and endorsement

The process for revising the standard has included consultation with the Delirium Clinical Care Standard Topic Working Group, an open request for public feedback, a targeted consultation process with potential endorsing organisations and internal review through the Commission’s processes.  

The standard has been endorsed by a number of key organisations.

Evidence base

A review was carried out to assess consistency with key guidelines released since the standard was first published, including those from the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network, and the current Therapeutic Guidelines (eTG). 

Transition to the 2021 Delirium Clinical Care Standard

The 2016 Delirium Clinical Care Standard and resources have been superseded by the 2021 Delirium Clinical Care Standard. Health service organisations should start implementing the 2021 Delirium Clinical Care Standard. Assessments based on the 2021 Delirium Clinical Care Standard will commence from 1 September 2022, when assessment of some clinical care standards indicators will be required.

The advisory AS22/01 - Advice on implementing the updated Delirium Clinical Care Standard clarifies requirements around the transition to the new standard for health service organisations assessed to the National Safety and Quality Health Service (NSQHS) standards.

If you have any questions about the Delirium Clinical Care Standard please email ccs@safetyandquality.gov.au