NPMT

Tutorial

Delirium

Introduction

The Delirium module aims to give an overview and approach to recognizing and managing delirium on the wards. The session should include an overview of the Confusion Assessment Method (CAM) and cognitive screening. It also involves discussion of how to recognize the predisposing and precipitating risk factors of delirium, and how these risk factors can be minimized in a multidisciplinary environment.

Content Contributors:

Author: Dr Amelia Welch

Content Approval: Dr Sunil Gupta

Version History
Version 1: April 2020

This module forms part of the Core Curriculum.

  • It requires <15 minutes preparation.

  • It can be taught in 1 hour

Preparation materials: MMSE, Behavioral chart, Fluid balance & bowel charts (paper or electronic)

Teaching approach

As with all modules, familiarise yourself with the NPMT principles.

The session aims to:

  • Teach students to identify delirium and appropriately assess delirious patients

  • Understand the importance of early identification or delirium and its causative factors

  • Conduct a comprehensive evaluation of delirious patients, including history, examination, cognitive screening, and ordering appropriate investigations

  • Understand and be able to practice the principles of delirium management, and the importance of non-pharmacological measures

  • Give an overview of the prevention of delirium in a hospital setting

Tips & Tricks:

  • Be as interactive as possible

  • Emphasize that delirium should be considered a medical emergency, as it may be a manifestation of an underlying critical illness

  • Incorporate review of behavioral, fluid balance and bowel charts, and nutritional notes into the session

  • Bring copies of MMSEs for students to familiarise themselves with

  • Focus on the risk factors for delirium that are modifiable and reversible, and encourage students to suggest how they might go about identifying and managing these on the wards

From our feedback, the more interactive and ‘put on the spot’ you make the session, the more valuable it will be. Having students think on the spot and share their ideas in a non-threatening environment is key to making the session light-hearted and collaborative so that they can apply what they have learnt at medical school to a clinical patient.

Resources:

Other Resources