Delirium Care Pathways
Strategies to Prevent Delirium
The following table lists the environmental strategies and clinical practice strategies to prevent delirium.
| Environmental Strategies | Clinical Practice Strategies |
|---|---|
| Lighting appropriate to time of day - windows with a view to outside, curtains and blinds open during the day, and minimal lighting at night may reduce disorientation Provision of single room - reduces the disturbance caused by staff attending other patients in the same room Quiet environment especially at rest times - noise reduction strategies (eg: use of vibrating pagers rather than call bells) Provision of clock and calendar that clients can see Encourage family and carer involvement - includes encouraging them to visit Encourage family/carer to bring in client's personal and familiar objects Avoid room changes - frequent changes may increase disorientation | Encourage/assist with eating and drinking to ensure adequate intake Ensure that patients who usually wear hearing and visual aids are assisted to use them Regulation of bowel function - avoid constipation Encourage and assist with regular mobilisation Encourage independence in basic ADLs Medication review Promote relaxation and sufficient sleep - can be assisted by regular mobilisation, massage, encouraging wakefulness during the day Manage discomfort or pain Provide orienting information including name and role of staff members Minimise use of indwelling catheters Avoid use of physical restraints Avoid psychoactive drugs Use of interpreters and other communication aids for CALD patients/clients Use of ATSI liaison officer for ATSI populations |
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