Hospital-acquired delirium is associated with several negative consequences, such as prolonged hospitalization. Programs targeted at delirium prevention and treatment may affect these outcomes.  

In this retrospective cohort study, we compared outcomes before and after a delirium care pathway was implemented on a general medicine ward. The pathway included admission delirium risk assessment, delirium screening by nurses every twelve hours, and a targeted non-pharmacologic care bundle for high risk and delirious patients. We included all non-intensive care unit patients ≥50 years old hospitalized for at least 24 hours on the general medicine ward from 1/9/2016–1/8/2017 (pre-pathway) and 1/9/2017-1/8/2018 (post-pathway). Primary outcome was length of stay. Secondary outcomes included restraint use, safety attendant use, hospitalization cost, and 30-day readmission. Delirium screening was implemented with the care pathway, so delirium rates were only measured in the post-pathway period. Outcomes were compared between time periods using multivariable generalized linear, Poisson and logistic models as appropriate, adjusting for clinical variables that were significantly different between groups.