The Australian Delirium Clinical Care Standard: not just another brick in the wall

Abstract

Delivering delirium care is challenging. Systems may not be set up to facilitate good delirium practice and staff may have low baseline understanding of how to spot, stop and treat delirium. In this context, delirium guidelines are especially important. In this article, we review the 2021 Australian Delirium Clinical Care Standards. The care standards are different to guidelines insofar as they focus on main presentations and represent eight quality statements describing the best evidence-based care patients with delirium should be offered. The standards speak to three different audiences: consumer, clinician and healthcare organisations. As such, they provide some system-level solutions to practice-level problems. They incorporate latest evidence and reflect the sway away from prescribing to treat delirium, stating that antipsychotics should be avoided. Furthermore, they promote inclusivity of families and carers in delirium care processes as an important medium to engender good practice. Limitations include the fact that they extend to delirium in multiple settings where different approaches may be necessary. They also lack the granularity of being able to provide recommendations on a greater range of drugs that might be used and assume settings are ready to introduce best delirium practice. In sum, they represent an important step forward for delirium knowledge translation and are particularly relevant for patients in the geriatric setting. The guidelines though are constrained as to what they can advocate due to research gaps especially into treatment of delirium.