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Delirium Screening in the Emergency Department: Barriers, Enablers and Alignment With Clinical Standards-A
Barbara Zangerl1,2, Jared-Tyrell Ah-Leong1, Joshua Wilcox1
1The Prince Charles Hospital, Chermside, Queensland, Australia.
Emergency Medicine Australasia : EMA
|June 17, 2026
Summary
Delirium screening for older adults in emergency departments (EDs) is inconsistent, with only 4.2% of eligible patients screened. Barriers include time, environment, and unclear roles, hindering adherence to national standards.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Healthcare Quality Improvement
Background:
- Delirium is a prevalent and serious condition in older adults within emergency departments (EDs).
- Current delirium screening practices in EDs often do not meet national expectations.
- Implementing standardized screening is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate current delirium screening practices in a metropolitan ED.
- To identify barriers and enablers for implementing delirium screening aligned with the Australian Delirium Clinical Care Standard.
Main Methods:
- A mixed-methods quality assurance study was conducted.
- Included a retrospective audit of 238 medical records for patients aged ≥65 years.
- Incorporated semi-structured interviews with nine ED staff members.
Main Results:
- Only 4.2% of eligible patients underwent delirium screening, primarily by specialist teams during weekdays.
- Nurses recognized risk factors but viewed screening as reactive, not routine.
- Key barriers included time constraints, environmental issues, lack of digital integration, and role ambiguity.
Conclusions:
- Delirium screening in EDs remains inconsistent and reliant on specialist input.
- Enhancing adherence to national standards requires integrating screening into routine nursing workflows.
- Clearer role delineation and systematic prompts are needed for comprehensive assessment of older patients.
