Critical Bytes: Delirium - look again

Course overview

Delirium affects patients in every care setting, yet it is often unrecognised. This is particularly true for hypoactive subtype, which is quiet, easily mistaken for fatigue, depression or dementia. Delirium is independently associated with an increase in falls for hospitalised patients and a higher rate of recurrent falls. Delirium can be a marker of acute illness and is associated with a higher mortality rate in older hospitalised patients. In ICU patients it is associated with longer ventilation, ICU and hospital length of stay.

The danger of missing what's underneath these changes in cognition should give us pause to look again. What's triggering the delirium? Is it sepsis, hypoxaemia, hypercapnia, hypoglycaemia, pain, medication toxicity, stroke or urinary retention?  Attributing acute cognitive change to age, dementia, or the hospital environment can delay recognition of the physiological deterioration driving it.

This case based webinar follows four patients through primary care, acute care, the perioperative setting and intensive care, then integrates the principles through a single patient's journey across the continuum of care. Content is structured around the Delirium Clinical Care Standard (ACSQHC) and NSQHS Comprehensive Care Standard (standard 5), with live polling and discussion throughout.

Course outline

• Recognition of delirium and its subtypes, including the under-detected hypoactive presentation.
• Establishing cognitive baselines and use of validated screening tools - appropriate for the different clinical settings.
• Avoiding diagnostic anchoring when delirium coexists with dementia, depression or acute illness.
• Identifying predisposing and precipitating contributors and targeting reversible causes.
• Non-pharmacological prevention and management, and the role of judicious pharmacological approaches.
• Sedation and the changing phenotype in critical care.
• Safe transition of care including intra-hospital transfers and discharge.

Why you should attend

This webinar will help you move beyond simply identifying confusion to understanding what has changed, why it may have changed and what to do next. Content is mapped to the Delirium Clinical Care Standard and NSQHS Standard 5. Directly applicable to any clinical role in primary, acute, perioperative and critical care. This session provides the opportunity to work through patient case studies, respond to clinical questions via polls and access resources you can apply to your clinical practice improving patient care.