Delirium is an acute state of confusion that is often seen in older patients after major orthopedic surgical procedures. It is associated with increased costs of care, morbidity, delayed functional recovery, and prolonged hospital stay. Identification of predictive risk factors, early diagnosis and treatment, and implementation of environmental controls can minimize the impact of postoperative delirium. This project measured pre- and post intervention compliance with best practice in the prevention and management of postoperative delirium.

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Overall the project achieved improvements in compliance with best practice standards. A number of delays and barriers contributed to some of the planned interventions not being fully implemented at the time of the follow-up audit. Contributing factors included the lack of electronic capabilities, some processes not being fully embedded into routine clinical workflows, lack of staff time, and identification of an additional organizational barrier relating to practical issues in providing patient education at discharge. A second action cycle is recommended in an attempt to further improve compliance, ensure intervention fidelity, and embed practices into routine daily workflows to positively impact patient and organizational outcomes.