Our grantee partners at the University of California, San Francisco are making great strides to tackle an enormous challenge too often experienced by patients when hospitalized: delirium. Each year, more than seven million people who have been hospitalized experience delirium, a state of mental confusion that can occur as a result of illness, surgery or with the use of some medications. More than 60 percent of patients with delirium are not recognized by the health care system. This is due in large part to understanding how to identify it and addressing it quickly. 

Clinical nurse specialist, Hildy Schell-Chaple, has worked in the ICU at UCSF for 27 years. She is part of an interdisciplinary group leading efforts to better prevent and manage delirium in the ICU. “It used to be that we associated delirium only with the hyperactive form, but one important finding of our studies is that hypoactive delirium – where patients are inattentive or unresponsive – is more common and underdiagnosed,” shared Chaple. This recognition has helped change understanding of the condition’s prevalence and is leading to delirium prevention.

In an article from UCSF “More Common and More Harmful Than Once Believed, Delirium Takes Center Stage,” a team of professionals share how they are understanding and addressing delirium. Efforts include educating different types of clinicians and leveraging the skills of bedside nurses for formal screenings, applying the Society of Critical Care Medicine’s guidelines and the ABCDEF bundle, and refining interdisciplinary rounds to ensure delirium prevention remains on everyone’s radar. To keep delirium prevention top of mind, UCSF, in partnership with Johns Hopkins Medicine, is rolling out Project Emerge which includes a tablet-based application with a color-coded wheel that addresses seven elements of harm reduction, including delirium prevention. “It’s a dynamic checklist that we’ll discuss at the end of the nurse’s and resident’s presentation, before we make a detailed plan for the day,” notes critical care specialist Matthew Aldrich.

You can read more about UCSF’s efforts to prevent delirium here.