Table 1.

Principles of effective and evidence-based delirium prevention and management.

Future Hospital Commission's principles of care	Relevance to delirium	Potential interventions
Fundamental standards of care must always be met	Delirium is under-recognised, preventing patients from receiving appropriate care	Implementation of a validated screening tool
Patients have effective and timely access to care, including appointments, tests, treatments and moves out of hospital
Care is designed to facilitate self-care and health promotion	There is a notable lack of awareness of delirium among the public consciousness	Patient information leaflets, teaching videos involving patients and carers, public lectures and awareness events
Good communication with and about patients is the norm	Poor handover between staff regarding patients with delirium prevents its recognition. Patients with delirium may be labelled as ‘poor historians’	Interprofessional education regarding delirium and simulation training for patients with delirium can provide a powerful learning experience and prompt for reflection
Staff are supported to deliver safe, compassionate care, and are committed to improving quality	Negative attitudes and a lack of ownership may exacerbate the patient's fear and anxiety	Patient and public involvement within interprofessional teaching interventions is a powerful potential method for driving attitudinal change
Patient experience is valued as much as clinical effectiveness	Delirium is distressing for patients, carers and healthcare professionals
All patients have a care plan that reflects their individual clinical and support needs	Delirium has many causes and so targeted interventions to prevent and treat delirium must be tailored to individual patients	Relatives can play a vital role, facilitated by encouraging more open visiting and by completing a tool, such as the Alzheimer's Society ‘This is me’
Patients do not move wards unless it is necessary for their clinical care	Changes in environment can cause disorientation and may contribute to delirium	Those with or at high risk of delirium should be highlighted as inappropriate candidates for boarding
Robust arrangements for the transfer of care are in place	Delirium is associated with an increased risk of incident dementia	Robust communication between secondary and primary care, including using the term ‘delirium’, helps to highlight those who may need further follow up regarding their cognition following discharge