Delirium is a common disorder characterized by a recent onset of symptoms related to impaired cognitive function. In addition to causing stress to patients and families, delirium increases health care costs due to longer hospital stays and the need for long-term care. With this issue in mind, the National Institute of Health and Clinical Excellence (NICE) developed guidelines for preventing delirium in patients 18 years or older in a clinical setting. The NICE multidisciplinary guideline development group - which consisted of physicians, psychiatrists, specialist nurses, a care home manager, and patients - posed review questions, discussed evidence, and formulated recommendations which were opened for public and stakeholder comment prior to finalization.

The guideline group made 13 specific recommendations that addressed the stability of the care environment and the provision of a multicomponent intervention package tailored for persons at risk for delirium. The intervention package included assessment and modification of factors that may precipitate delirium, including cognitive impairment or disorientation, dehydration or constipation, hyupoxia, infection, immobility or limited mobility, taking several medications, pain, poor nutrition, sensory impairment, and sleep disturbance. A complete list of recommendations can be found here.

In a related editorial, Annals editor, Christine Laine, MD, MPH, summarizes the Institute of Medicine's Proposed Standards for a Trustworthy Guideline to help readers discern which guidelines they should trust. Dr. Laine and her co-authors believe that high-quality practice guidelines promote excellence in care, which is why Annals is eager to publish guidelines that meet the rigorous IOM standards.

Source
Annals of Internal Medicine