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Screening for Delirium
It is important to screen new patients for delirium if they are at risk of delirium or if the patient’s condition has changed and you suspect delirium. There are a number of tools you can use to screen for delirium.
For example The Single Question in Dementia (SQiD):
Or the 4TA (NICE 2020):
Along with the Observational Scale of Arousal (OSLA) (NICE 2020):
Eyes Opening
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Open on arrival?
Open to voice?
Eyes Contact
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Holds eye contact?
Eyes wandering
Posture
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Slumped in chair?
Lying in bed?
If delirium is suspect from the screening, a full assessment should be completed by a competent practitioner and a plan of care developed using for example the TIME Bundle (NICE 2020).
Some useful resources:
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Healthcare Improvement Scotland Delirium Toolkit
Greater Manchester Community Delirium Toolkit
NICE Guidelines (2020) Dementia Assessment and Diagnosis
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