Ian Tyrrell

Mrs. T, 76, background of mild dementia. Admitted with COPD exacerbation. Doing well. Discharge planned for day 3. AM, night 2: bed manager moves her to a different ward. Bed pressures. Wheeled through dark corridors. New bay. Different nurses. Belongings in bags. By morning: frightened, disorientated, and calling out. Delirium diagnosed. Workup: all normal. No infection, no medication change, no pain. The cause: probably mostly the ward move itself. Sleep deprivation + loss of orientation cues + unfamiliar environment = iatrogenic delirium. We do this every night, in every hospital. Her avoidable delirium was very costly to her: reduced confidence, worse mobility, lasting traumatic memories. It also meant 4 extra days of hospital bed costs. ↳ How many cases of delirium in your hospital are caused by inadequate care? #acutecare #dementia