Delirium can Delirium Fact Sheet result in: Delirium definition:Disturbance in attention and awareness; change in cognition An increased length of stay that is not accounted for by dementia; develops over a short period (hours to days) and fluctuates throughout the day.

Average Did you know? LOS +10.31 days Up to Up to 80% 67% of patients - of patients 30 40% who are of delirium with dementia mechanically Risk for readmission cases are present with ventilated preventable. or develop develop delirium. delirium.

Does your hospital use a delirium assessment? Average cost per YES If a patient develops delirium or to prevent delirium, consider the following interventions patient +$91,363 1. Non-pharmacological measures: Appropriate pain assessment and management, evaluate hydration, reduce use of tethers, treat medical condition (i.e. infections, constipation, etc.) 2. Medication management: Avoid or discontinue high-risk medications (i.e. antihistamines- first generation, Increased risk of falls benzodiazepines, and anti-cholinergics, opioids, and hypnotics, etc.) 3. Management of ventilated patients: Use RASS to titrate level of sedation and minimize deeper levels.

NO If your hospital does not use a delirium assessment, here is what you can do 1. Ask hospital leadership why an assessment is not used. In MN, 24% of serious 2. Give leadership a copy of the MHA Delirium SBAR that links delirium prevention to improved outcomes and injury/death adverse decreased costs. health event falls in a. The MHA website has information on different assessments to use, such as the Confusion Assessment Method, 2016-17 were related one of the most common tools used by clinical staff. to dementia/delirium b. Contact MHA staff for delirium-specific support: Naira Polonsky, [email protected].

Additional actions Delirium can also • Documentation: History of cognitive impairment or previous delirium, factors causing delirium, management and result in: evaluation of treatment. • Long-term cognitive • Communication with care team members: New diagnosis or suspected delirium, treatment plan, and notification of impairment any changes in condition. • PTSD • Delirium can be scary and confusing for the patient and family, so communication between the physician and • Need for family is vital. Talk with the patient and family regarding the long-term implications of delirium and how it differs transitional care from dementia.

Rate of delirium (patients age 70 or older) in Minnesota HIIN hospitals ICD-10 codes for delirium utilized by the 115 of 123 hospitals reporting a 21% increase from MN-HIIN baseline Minnesota Hospital Association

F05 Delirium due to known physiological condition G93.40 Encephalopathy, unspecified G93.41 Metabolic Encephalopathy G93.49 Other encephalopathy I67.83 Posterior reversible encephalopathy syndrome G92 Toxic encephalopathy