Stillbirth Clinical Care Standard

The Commission is developing a Stillbirth Clinical Care Standard to improve the appropriateness of care for stillbirth prevention, and the quality of bereavement care following perinatal loss.

Indicators for the Delirium Clinical Care Standard

Indicators have been developed to support monitoring of the care recommended in the Delirium Clinical Care Standard. Clinicians and health service organisations can use the indicators to support local quality improvement activities.

Transition from hospital care

Quality statement 8

Before a patient with persistent or resolved delirium leaves hospital, an individualised comprehensive care plan is developed collaboratively with the patient and their family or carer. The plan describes the patient’s post-discharge care needs and includes strategies to help reduce the risk of delirium and related complications, a summary of changes in medicines and any other ongoing treatment. This plan is provided to the patient and their family or carer before discharge, and to their general practitioner and other regular clinicians within 48 hours of discharge.

Avoiding use of antipsychotic medicines

Quality statement 7

Antipsychotic medicines are not recommended to treat delirium. Behavioural and psychological symptoms in a patient with delirium are managed using non-drug strategies.

Preventing complications of care

Quality statement 6

A patient with delirium receives care to prevent functional decline, dehydration, malnutrition, falls and pressure injuries, based on their risk.

Identifying and treating underlying causes

Quality statement 5

A patient with delirium is offered a set of interventions to treat the causes of delirium, based on a comprehensive assessment that includes relevant multidisciplinary consultation.

Assessing and diagnosing delirium

Quality statement 4

A patient with cognitive impairment on presentation to hospital, or who has an acute change in behaviour or cognitive function during a hospital stay, is promptly assessed using a validated tool by a clinician trained to assess delirium. The patient and their family or carer are asked about any recent changes in the patient’s behaviour or thinking.

A diagnosis of delirium is determined and documented by a clinician working within their scope of practice.

Patient-centred information and support

Quality statement 3

A patient at risk of delirium and their family or carer are encouraged to be active participants in care. If a patient is at significant risk or has, delirium, they and their family or carer are provided with information about delirium and its prevention in a way that they can understand. When delirium occurs, they receive support to cope with the experience and its effects.

Interventions to prevent delirium

Quality statement 2

A patient at risk of delirium is offered a set of interventions to prevent delirium and is regularly monitored for changes in behaviour, cognition and physical condition. Appropriate interventions are determined before a planned admission or on admission to hospital, in discussion with the patient and their family or carer.

Early identification of risk

Quality statement 1

A patient with any key risk factor for delirium is identified on presentation and a validated tool is used to screen for cognitive impairment, or obtain a current score if they have known cognitive impairment. Before any planned admission, the risk of delirium is assessed and discussed with the patient, to enable an informed decision about the benefits and risks.

Quality statements

The Delirium Clinical Care Standard includes eight quality statements describing the key components of care to improve the prevention of delirium in patients at risk and the early diagnosis and treatment of patients with delirium.

Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard

The Commission is developing an Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard. This standard will guide clinicians and health service organisations on the appropriate use and review of opioid analgesics for managing acute pain in acute care settings. It will also inform consumers about the care they can expect to receive when opioid analgesics are prescribed for acute pain.

Sepsis Clinical Care Standard

The Commission is developing a Sepsis Clinical Care Standard to provide guidance to clinicians and health service organisations when investigating and managing sepsis, and information to consumers about the care they can expect to receive.