Delirium, nursing practice and the future

The preceding papers have outlined the issues of under-recognition of delirium, aspects of assessment to improve this situation and presented an alternative discursive construction of delirious patients. With respect to the understandings from the first two papers, the authors intend to suggest a direction for future practice and research in the area of delirium. The discussion will start with an overview of current international practice. Approaches focussing on the specific care of team members or on multidisciplinary care have been reported as well as approaches that focus on a clinical expert such as a nurse specialist or those that focus care of patients with delirium in a specific identified clinical setting. The literature represents variable evidence of the success, or otherwise, of different initiatives. The authors intend to provoke debate on the care of delirious patients and indicate the priorities for the future management of delirium.