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A psychoeducational intervention increases use of a delirium protocol by Neurologists and Neurosurgeons in patients with brain disorders

Published online by Cambridge University Press:  23 November 2020

S. Patel Open the ORCID record for S. Patel [Opens in a new window] ,
C. Carey Open the ORCID record for C. Carey [Opens in a new window] ,
D. Cotter  and
K. C. Murphy
S. Patel*
Affiliation:
Sligo/Leitrim Mental Health Services, Sligo, Ireland
C. Carey
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
D. Cotter
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
K. C. Murphy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
*
*Address for correspondence: C. Carey, Senior Registrar in Psychiatry, Department of Liaison Psychiatry, Beaumont Hospital, Dublin 9, Ireland. (Email: corneliacarey1@gmail.com)
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Abstract

Objectives:

Over 50% of inpatients with neurological disorders may present with a co-morbid psychiatric illness. Delirium has a reported point prevalence of 20% in hospital inpatients and is frequently undetected. We aimed to (1) examine inpatient referrals to a Liaison Neuropsychiatry service and (2) review the diagnosis and management of delirium before and after an educational intervention.

Methods:

An initial 6-month audit of referrals to the inpatient Liaison Neuropsychiatry service was conducted in 2018. We then undertook a psychoeducational intervention to raise awareness of the diagnosis and management of delirium. We conducted a re-audit of referrals to the service in 2019.

Results:

On initial audit, of 84 referrals, the most common referral was for mood (38%; n = 32). Just 4% (n = 3) had a specific delirium query. Following assessment by Neuropsychiatry, organic disorders (43%; n = 32), including delirium (33%; n = 25), were the most common diagnoses. On re-audit, of 86 referrals, mood assessment remained the most common reason for referral (38%; n = 33) and 2% (n = 2) were referred for possible delirium. Organic disorders remained the most common diagnoses (53%; n = 45) including delirium (38%; n = 32). We found a significant increase in the use of the delirium protocol from 12% (n = 3) on initial audit to 47% (n = 15); p < 0.01 on re-audit despite no increase in the number of specific delirium queries.

Conclusions:

A psychoeducational intervention improves the management of delirium by Neurologists and Neurosurgeons in patients with brain disorders.

Keywords

DeliriuminterventionNeuropsychiatry
Type
Audit
Information
Irish Journal of Psychological Medicine , Volume 40 , Issue 2 , June 2023 , pp. 273 - 281
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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Footnotes

†

These authors contributed equally to this work.

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