Nurses' usage of validated tools to assess for delirium in general acute care settings: A scoping review

Delirium occurs in 10-30% of hospitalised adults and is associated with an increased risk of mortality and morbidity. Best practice guidelines recommend the use of validated assessment tools for delirium. However, these tools are infrequently utilised, and delirium is routinely missed.

To explore validated assessment tool usage by registered nurses in general acute care settings to assess for delirium, and the barriers and facilitators to their use.

This scoping review was organised in accordance with the Joanna Briggs Institute methodology for scoping reviews. Boolean operators were used in combination with key search terms from the research questions. Sources were analysed using frequency counts and results were mapped descriptively.

CINAHL, PubMed (MEDLINE), Web of Science, Scopus, Google Scholar, and Bielefeld Academic Search Engine were searched in February 2025.

Sources that provided a focus on registered nurses working in general acute care settings and their experiences using validated delirium assessment tools were considered for this scoping review.

Forty studies were included in this scoping review. Validated assessment tools were not used frequently by nurses to assess for delirium. Multiple barriers to using validated assessment tools were identified, with the most reported being organisational barriers. Nurses identified "opportunities to learn" as facilitators to using validated assessment tools.

Notable heterogeneity among assessment practices were identified. Despite the availability of various validated assessment tools for delirium, usage rates remain low. Nurses have identified numerous barriers to their use, and these must be addressed to ensure accurate delirium diagnosis.

This scoping review was registered on the 15th of January 2025 on Open Science Framework at https://osf.io/6qegb.