Delirium diagnosis, risk reduction, and management in acute services (81)


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Be aware that people in hospital may be at risk of delirium. This can have serious consequences (such as increased risk of dementia and/or death), may increase their length of stay in hospital and their risk of new admission to long-term care.

The TIME checklist should be used to prompt good delirium risk reduction, diagnosis and management – it consists of a 4AT and the 4 steps: Think, Investigate, Manage and Explain & Explore

This guideline can be used in all acute areas managing adult patients with the exception of Anaesthetics and Intensive Care where although the principles are the same there are differing practical implications. Practitioners in these areas should refer to local policies or to SIGN 157. This guideline. does not cover primary care (including care homes), children and young people (under 18 years), people receiving end of life care, people with intoxication and/or withdrawing from drugs or alcohol or with delirium associated with these states. Medical, Nursing and Allied Health Professionals (AHPs) who work in areas where people are at risk of delirium should familiarise themselves with the guideline.


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Acute / All Inpatient
Mental Health

Last reviewed: 01 May 2020

Next review: 01 January 2023

Author(s): Hazel Miller

Version: 5

Approved By: Acute Services Division Clinical Governance Group

Document Id: 81