Delirium screening in an acute geriatric ward by nurses using 4AT: results from a quality improvement project

We conducted a retrospective chart-based analysis based on a quality improvement project in an acute geriatric ward. Delirium screening with the 4AT was performed by nurses within 24 h after hospital admission. Delirium according to DSM-5 criteria was diagnosed retrospectively based on review of patient records.

In total, 59 patients (mean age 86 years) were included. The prevalence of delirium was 36%. Two out of three patients recovered from their delirium within four days after onset. The sensitivity and specificity of the single-point assessment with 4AT performed by nurses were 50.0% [95% confidence interval (CI) 27.2-72.8] and 86.2% (95% CI 68.3-96.1).

Patients admitted to the acute geriatric ward had a high prevalence of delirium. The sensitivity of the 4AT performed by nurses for delirium was lower than in previous studies where it was undertaken by experienced geriatricians or delirium researchers.