Introduction Delirium affects up to 50% of older individuals within hospital environments, with a notable occurrence in 30% of those aged 65 and above in emergency departments. This QIP aimed to enhance the early recognition of delirium by implementing the 4AT assessment and optimise assessments and investigations by implementing the Delirium Bundle. Method A survey involving 39 doctors was conducted to evaluate their comprehension of delirium and awareness of the Delirium Bundle. PDSA 1 involved retrospective data analysis of medical records for patients admitted with delirium and used as a preliminary baseline to evaluate how the delirium bundle is being utilised. PDSA 2 integrated multiple teaching sessions and the implementation of the Delirium Bundle, assessing the effectiveness of these interventions. Results In PDSA 1, twenty-nine patients were identified. None of the patients had a 4AT assessment done. Twenty patients (69%) had a haematological screen done, eight patients (27%) had an ECG done, twenty patients (69%) had a CXR done, eighteen patients (62%) had an MSU test done, eight patients (28%) had cultures done, and twenty-three (79%) had a CT head scan done. In PDSA 2, thirty patients were identified. Seven patients had a 4AT assessment done, sixteen patients (53%) had a haematological screen done, nineteen patients (63%) had an ECG done, twenty-two patients (73%) had a CXR done, fifteen patients (50%) had an MSU test done, fourteen patients (47%) had cultures done, and 20 patients (67%) had a CT head scan done. Conclusion The implemented changes showed effectiveness with increased 4AT assessments and enhanced confusion screening. Improvements in assessments and investigations for diagnosed delirium patients were evident. To further enhance efforts, future initiatives include incorporating the 4AT assessment in clerking booklets, conducting continuous teaching sessions, and displaying posters in relevant wards.

中文翻译：

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2192 在患者管理中实施 4AT 和谵妄集束化——一项质量改进项目


简介 谵妄影响医院环境中高达 50% 的老年人，在 65 岁及以上的老年人中，有 30% 的人在急诊科发生得尤为明显。该 QIP 旨在通过实施 4AT 评估来增强对谵妄的早期识别，并通过实施 Delirium Bundle 来优化评估和调查。方法 进行了一项涉及 39 名医生的调查，以评估他们对谵妄的理解和对谵妄束的认识。PDSA 1 涉及对因谵妄入院的患者的医疗记录进行回顾性数据分析，并用作评估谵妄束如何利用的初步基线。PDSA 2 整合了多个教学课程和 Delirium Bundle 的实施，评估了这些干预措施的有效性。结果 在 PDSA 1 中，确定了 29 例患者。没有患者进行 4AT 评估。20 例患者 （69%） 进行了血液学筛查，8 例患者 （27%） 进行了心电图检查，20 例患者 （69%） 进行了 CXR，18 例患者 （62%） 进行了 MSU 检测，8 例患者 （28%） 进行了培养，23 例 （79%） 进行了头部 CT 扫描。在 PDSA 2 中，确定了 30 例患者。7 例患者进行了 4AT 评估，16 例患者 （53%） 进行了血液学筛查，19 例患者 （63%） 进行了心电图检查，22 例患者 （73%） 进行了 CXR，15 例患者 （50%） 进行了 MSU 检测，14 例患者 （47%） 进行了培养，20 例患者 （67%） 进行了头部 CT 扫描。结论 实施的更改在增加 4AT 评估和加强混淆筛查方面显示出有效性。对诊断为谵妄患者的评估和调查的改善是明显的。 为了进一步加强工作，未来的举措包括将 4AT 评估纳入文书小册子、进行持续的教学课程以及在相关病房张贴海报。