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Screening for delirium: the process involved
- All settings when there is a sudden change in behavior or cognition, there is an abrupt decline in ADL performance, or there is sudden deterioration in the person’s condition;
- Community and residential care settings when resident or client at higher risk of developing delirium, such as on return from hospital admission; or when acutely unwell; or
- High risk hospital settings, as part of screening process repeat frequently (for example, daily); if decline in score by 2 or more points (if using MMSE, AMT), or if high level of suspicion,
Conduct baseline Cognitive Function Assessment to assess cognitive function. This may involve use of tools such as MMSE or AMT on admission to health care setting.
If abnormal cognitive function OR change from pervious assessment OR high level of suspicion that the person has delirium, conduct formal diagnosis using a tool and/or notify expert in delirium diagnosis, such as nurse, medical staff or general practitioner.
If the baseline Cognitive Function Assessment is normal, or no change from previous assessment, repeat cognitive function in the following settings:
Then seek formal diagnosis using a tool and/or notify expert in delirium diagnosis – nurse or medical staff, general practitioner.
Adapted from: Clinical Epidemiology and Health Services Evaluation Unit 2006, Clinical Practice Guidelines for the Management of Delirium in Older People, Victorian Government Department of Human Services, Melbourne, Victoria