Delirium Care Pathways

Preventative Strategies for Delirium

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To view and print the flowchart as a PDF file, click here: Preventative Strategies Flowchart (PDF 457 KB).
To view and print the flowchart as an image, click here: Preventative Strategies Flowchart (JPG 218 KB).

Has the patient or client been identified as potentially suffering from delirium?

If yes,

step 1, conduct baseline cognitive assessments (People to use service/facility preferred diagnostic and assessment tools or other relevant material)

Refer to the Cognitive function assessment tools on page 3;

ensure appropriate referral is made;

and refer to the known risk factors for the development of delirium on page 4.

Does the patient or client have a cognitive impairment?

If no,

include in the care plan, strategies to prevent delirium on page 5;

screening at regular intervals for change in cognitive function at page 3; and

refer to the risk factor assessment and management at page 4.

If yes, proceed to step 2

Determine any changes in cognitive function (refer to information from patient/client, carer, GP, medical record or facility assessments).

Has there been a recent change in cognitive function?

If no,

refer to Poole’s Algorithm on Differential diagnosis at page 6, and include in the care plan, strategies to prevent delirium on page 5;

screening at regular intervals for change in cognitive function at page 3; and

refer to the risk factor assessment and management at page 4.

If yes, proceed to step 3,
conduct assessment for delirium (refer to delirium diagnostic tools for diagnosis by Expert at page 7. People to use service/facility preferred diagnostic and assessment tools or other relevant material).

Does the patient have a confirmed diagnosis of delirium?

If yes, adapt the care plan.
Consider who is consenting to care, refer to page 8 to 10 to identify and address causes at, refer to page 11 for management of symptoms, pharmacological management at page 12, refer to page 13 to provide supportive care, prevent complications as outlined on page 5, monitor resolution following facility guidelines, manage modifiable risk factors as outlined on page 4, educate patient and family, give facility pamphlet on page 14, considering the use of the interpreter, and refer to advanced care plan.

If the patient does not have a confirmed diagnosis of delirium, proceed to step 4, and consider the subclinical delirium.

Does the patient have symptoms of delirium?

If yes, adapt the care plan as per step 3.

If no, proceed to step 5 and monitor and respond to any sudden changes in cognitive function by repeating pathway.

* People to use service/facility preferred diagnostic and assessment tools or other relevant material.
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

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