ABSTRACT
Objectives
To describe detected delirium prevalence and current delirium-related practices in Australian and New Zealand healthcare sites.
Methods
This study was a sub-analysis of Australian and New Zealand data from an international cross-sectional survey conducted on World Delirium Awareness Day 2023. Delirium was identified using existing clinical practices on participating wards.
Results
Across 257 wards of varying specialties and acuities, detected delirium prevalence was 16% (n = 637/4033) at 8:00 AM and 16% (n = 609/3836) at 8:00 PM. Delirium assessment rates were 63% (n = 4033/6369) at 8:00 AM and 63% (n = 3836/6091) at 8:00 PM. Most wards (93%) used validated assessment tools, most commonly 4AT and CAM. Just over half (53%) assessed for delirium at least daily, whereas 37% only assessed in response to the sudden changes in consciousness or clinical condition. Written delirium protocols were common (91%). Non-pharmacological strategies were widely implemented, particularly ensuring adequate fluids (87%), mobilisation (84%) and pain management (84%). Frequent use of pharmacological interventions was often reported, particularly antipsychotics, including risperidone (36%), haloperidol (35%) and quetiapine (31%). Key perceived barriers to implementation of evidence-based delirium care were staff shortage (70%), lack of time to educate and train staff (53%) and missing knowledge (49%).
Conclusions
In Australia and New Zealand, delirium assessment practices have improved over time. Non-pharmacological strategies are widely used; however, antipsychotic use remains substantial. Workforce constraints, education gaps and system pressures may contribute to variability in delirium care delivery. Addressing these factors, alongside engagement with carers, may support further improvements in care. Ongoing surveillance through repeated surveys would help monitor trends in delirium care over time.