The management of delirium in the older adult in advanced nursing practice

Abstract

Delirium is a term used to describe an array of symptoms that indicate a disruption in cerebral metabolism, a condition that is often under-recognised, leading to delayed interventions. The condition is a common cause of older adults presenting in hospital, with significant morbidity and mortality associated with increased length of stay. A case study is used to illustrate the use of a diagnostic algorithm for older adults presenting with delirium to an advanced nurse practitioner (ANP)-led service. The clinical decision pathway provides four differential diagnoses, using the case study to put the decision-making process in context. The article demonstrates the ability of the ANP to practise at a high level of expertise as an autonomous practitioner and shows how the pathway supports the nurse to reach an accurate diagnosis. It shows that prompt and accurate diagnosis of delirium in older adults is crucial to avoiding the complications and cognitive decline associated with the condition.

Barriers to healthcare professionals recognizing and managing delirium in older adults during a hospital stay: A mixed‐methods systematic review

“…Nurses and healthcare professionals need specialist skills to identify complex patterns of signs and symptoms and confounders to make a timely diagnosis and management plan for delirium in the older person. Advanced and specialist nurse roles in the fields of delirium and dementia make an important contribution to advancing the care of the older person in hospital and following discharge from hospital; nurses leading on patient care but in collaboration with their multiprofessional colleagues (Carey et al., 2022; Davis & Price, 2023). Advanced and specialist nurses have expertise to navigate the challenges encountered during the patient journey and therefore have a key role in supporting patients and their families and friends.…”

“…with their multiprofessional colleagues (Carey et al, 2022;Davis & Price, 2023). Advanced and specialist nurses have expertise to navigate the challenges encountered during the patient journey and therefore have a key role in supporting patients and their families and friends.…”