Quality project to prevent delirium after hip fracture

Objectives: It has been demonstrated that a series of strategies supervised by a geriatrician can reduce the incidence of delirium in elderly hip fracture patients. The aims of this project were to determine if a geriatric registrar could introduce these strategies and alter the incidence of delirium in our orthopaedic unit. Methods: The program used quality improvement methods and included staff education and the use of a checklist to facilitate the use of the strategies. We counted the number of recommendations made, the subsequent adherence to the recommendations and the before and after monthly incidence of delirium. Results: The geriatric registrars made 424 recommendations (average six per patient) during a 3‐month intervention period, of which 89.9% were adhered to. Baseline data indicated an incidence of delirium of 10/28 cases (35.7%). Following introduction of the strategies, subsequent monthly incidences of delirium were 4/28 cases (14.3%), 3/22 cases (13.6%) and 2/21 cases (9.5%) (P < 0.035 compared with baseline). Conclusions: We conclude from this short program that methods proven to prevent delirium can be introduced into routine clinical practice and that this appears to prevent cases of delirium.