Useful Websites for Clinicians

This page is intended for clinicians. Patients and patient families seeking information on delirium should go to the page entitled For Older Adults and Caregivers.

Royal College of Physicians Online Publications: Prevention, Diagnosis and Management of Delirium in Older People

Developed by the Royal College of Physicians, these national British guidelines aim to provide healthcare professionals with a practical approach to the identification, prevention and management of delirium. While developed primarily with a view to hospital care, the principles within the guidelines are also highly relevant to intermediate and community care settings.

American Psychiatric Association (APA) Practice Guideline for Delirium:

This practice guideline, developed by the APA in 1999, provides an overview to approaches for delirium as of 1999.

Clinical Guidelines for the Management of Delirium in Older People:

This is a 121 page guideline developed specifically for the Australian health care environment by the Clinical Epidemiology and Health Service Evaluation Unit, Melbourne Health in collaboration with the Delirium Clinical Guidelines Expert Working Group. Commissioned on behalf of the Australian Health Ministers' Advisory Council (AHMAC), by the AHMAC Health Care of Older Australians Standing Committee (HCOASC). The first set of national (Australian) clinical practice guidelines for the management of delirium in older people.

Regional Geriatric Program of Toronto Website:

The Regional Geriatric Program (RGP) is a network of specialized geriatric service that "provides a range of hospital and community-based health care services for elders". Additionally, the site provides links to clinical resources, health in formation for seniors, continuing education opportunities for healthcare professionals in geriatric medicine, and a link to databases and journal publications.

ICU Delirium and Cognitive Impairment Study Group Website:

This site, developed by Vanderbilt University Medical Center, Veterans Affairs TN Valley Geriatric Research Education and Clinical Center (GRECC), provides information on delirium in the intensive care setting. The site contains explanations of terminology and etiology, treatment options (pharmacological and non-pharmacological), data on delirium and clinical outcomes including mortality, length of hospital stay, and cost. Also included is an online training manual for the Confusion Assessment Method for the ICU (CAM-ICU), a delirium monitoring instrument for ICU patients.

Geriatric Web:

This site, developed by the Division of Geriatrics at Palmetto Health Richland Hospital, University of South Carolina School of Medicine and the University of South Carolina, School of Medicine Library, includes extensive links to journal articles, practice guidelines, clinical trials, education resources, and clinical management of delirium.

The New York Statewide Resource Center for Geriatric Education:

The following information was obtained from the former New York Statewide Resource Center for Geriatric Education. The information is specific to delirium in the elderly and discusses causes of the disease, management of delirium as a healthcare provider, prevention of delirium in the elderly patient population, and education for patients.

Med News/National Cancer Institute - Supportive Care Statement for Health Professionals:

The information contained on the website from NCI discusses the prevalence of delirium in elderly patients with comorbid diagnoses of cancer. The content of the site includes definitions, epidemiology, and etiology of delirium, information on the impact of delirium on patient, family, and healthcare personnel, diagnosis and monitoring of delirious patients, and disease management.

Screening for ICU delirium:

This document, developed by the End of Life/Palliative Education Resource Center of the Medical College of Wisconsin, provides educational information on the importance of recognizing delirium in the ICU patient, and references tools helpful in doing so.

Screening for delirium, dementia, and depression in older adults:

The National Guideline Clearinghouse, an initiative of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, developed this website containing clinical practice guidelines and related documents.

Clinical Guideline for the Care and Treatment of Older People with Delirium in a Hospital Setting:

This is a summary guideline produced by Isle of Wight Healthcare, NHS Trust, to assist clinicians in routinely screening patients at risk for developing delirium and for developing appropriate plans of care and treatment.

A MAP of Delirium - A method for translating evidence into clinical practice:

This site describes the process used during the "A MAP of delirium" project at Royal Perth Hospital in Australia. The project goal was to assess, manage and prevent delirium in older patients admitted to an acute tertiary hospital.

Best practices for nursing care of the older adult: Practice Guideline for Nurses:

This site, developed by Vancouver Coastal Health, contains a clinical practice guideline by Northern Health titled Delirium. The practice guideline for nurses was written in October, 2005 includes the Confusion Assessment Method and PRISM Environment Assessment Tool Delirium Information Sheet.

Delirium, management of patients at risk or suspected:

This site, developed by the Credit Valley Hospital (Ontario, Canada), contains a clinical practice guideline for physicians to assist in the management of patients at risk or diagnoses with suspected delirium using DRAT (Delirium Risk Assessment Tool).

Management of delirium on the MAU:

Practical guidance for medical and nursing staff in identifying and managing patients with delirium. These guidelines are published on the University of Leeds, UK website.

National Guidelines for Seniors' Mental Health: The assessment and treatment of delirium:

The Canadian Coalition for Seniors' Mental Health facilitated the development of this 87 page document. Clinical practice guideline to improve the assessment, treatment, management and prevention of key mental health issues for seniors. Written by interdisciplinary teams of health care professionals.

The DADS Medical Quality Assurance vision for management of delirium:

The Texas Department of Aging and Disability Services vision for management of delirium in long-term care in Texas facilities. Includes links to MMSE, Neecham Confusion Scale, CAM.

Clinical Educational Resources for Dementia & Cognitive Loss:

Links to educational resources including: Screening and assessment tools for cognitive impairment or dementia, Providing care for persons with dementia, Other highly recommended Geriatric learning resources. This site was published by the Department of Interior Health, British Columbia.

Geriatric Emergency Management: An overview of delivery models, screening tools, and practice guidelines:

An overview document outlining some of the potential strategies for improving care of elderly in the emergency room and for assisting ER staff in addressing the specific needs of the elderly patient. Offers overview of the published literature on service delivery models, screening tools and practice guidelines specific to GEM. Developed by the Ontario Hospital Association (Ontario, Canada) in 2003.

Delirium Assessment:

Vanderbilt University Medical Center and Veterans Affairs TN Valley Geriatric Research Education and Clinical Center (GRECC). Links to CAM-ICU with training manual, instructional videos, FAQs, worksheets and translations, as well as link to hints on successful implementation. Also includes links to Intensive Care Delirium Screening Checklist.

Screening for delirium, dementia, and depression in older adults:

This is a 2003 document from the Registered Nurses Association of Ontario, which includes nursing best practice guideline for screening of delirium, depression and dementia in older adults.

Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult:

Published in the American Journal of Health-System Pharmacist (Volume 59, Jan 15, 2002), provides clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult.