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Updated: May 13, 2025

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
[Delirium code]
Marta Martínez-García1, Brian Dax Vásquez-Brolen2, Fátima Brañas1
1Servicio de Geriatría, Hospital Universitario Infanta Leonor. Madrid, España; Universidad Complutense de Madrid, Madrid, España.
Introduction:
Delirium, or acute confusional syndrome, poses a challenge for healthcare systems due to its significant economic impact and its effects on the health of hospitalized older adults. Therefore, implementing strategies for early detection and management should be a priority. The Delirium Code (DC) at the Hospital Universitario Infanta Leonor (HUIL) in Madrid aims to reduce the prevalence and incidence of delirium, as well as minimize its harmful consequences.
Methodology:
The DC is a screening, diagnosis, and early treatment program for delirium integrated into the hospital's routine clinical practice. It is led by the geriatrics department and applies to patients over 65 years old admitted to hospitalization units and/or emergency departments. Activation of the program in the hospital's information system is carried out by the nurse responsible for the patient after applying the Confusional Assessment method (CAM) screening tool and activating a specific marker that registers patients for intervention by the DC team.
Discussion:
Specialized geriatric care, with a key role played by the geriatric specialist nurse, is essential for optimizing the prevention, diagnosis, and treatment of delirium. Additionally, educational interventions aimed at healthcare professionals improve its recognition and documentation.
Conclusions:
The commitment of both hospital management and healthcare professionals, along with proper training, is essential for implementing a program of this kind. The DC is feasible, necessary, and should be considered a quality-of-care indicator.
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