title: Measuring delirium point-prevalence in two Australian palliative care inpatient units.
abstract: BACKGROUND
  Internationally, delirium prevalence in palliative care is reported to range between 26-88%, yet little is known about the occurrence of delirium in Australian palliative care inpatient populations.
  
  
  OBJECTIVE
  To: 1) ascertain 24-hour delirium point-prevalence in an Australian palliative care inpatient population; 2) test the feasibility and acceptability of the delirium measurement methodology.
  
  
  METHODS
  This was a prospective cross-sectional study. Delirium was measured in patients of two palliative care units using the Nursing Delirium Screening Scale, Memorial Delirium Assessment Scale and DSM-5 diagnostic criteria. Descriptive statistics were used to report patient demographics, palliative care phase, function, delirium measure completion, and proportion of patients with a positive screen and diagnosis.
  
  
  RESULTS
  Patients (n=47) had a mean age of 74 years (SD+10) and mostly malignant diagnoses (96%). All patients were screened for delirium, but few were capable of completing the Memorial Delirium Assessment Scale (n=2). One-third of patients (34%) screened positive for delirium and 19% were diagnosed as delirious according to the DSM-5.
  
  
  CONCLUSIONS
  The Nursing Delirium Screening Scale and physician application of DSM-5 proved feasible and acceptable, while the Memorial Delirium Assessment Scale did not. Patients' advanced age and proportions screening positive for delirium and diagnosed as delirious attest to the need to rapidly recognise, assess and respond to patients experiencing this distressing disorder while being cared for in palliative care inpatient settings.
authors.affiliation: PhD Candidate, School of Nursing, The University of Notre Dame Australia.
authors.forename: Annmarie
authors.initials: A
authors.lastname: Hosie
authors.affiliation: Professor, Calvary Health Care Sydney, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lobb
authors.affiliation: Professor, Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney.
authors.forename: Meera
authors.initials: M
authors.lastname: Agar
authors.affiliation: Dean, School of Nursing, Johns Hopkins University, Baltimore, US.
authors.forename: Patricia
authors.initials: P
authors.lastname: Davidson
authors.affiliation: Director, St Vincent's Health Network, Darlinghurst, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Chye
authors.affiliation: Professor, Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lam
authors.affiliation: Director, Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney.
authors.forename: Jane
authors.initials: J
authors.lastname: Phillips
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies
keywords: Assessment; Delirium; Diagnosis; Palliative care; Prevalence; Screening