Hip Fracture Clinical Care Standard: 3b-Proportion of patients with a hip fracture who were assessed for delirium following surgery
Indicator Attributes
Identifying and definitional attributes | |
Metadata item type: | Indicator |
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Indicator type: | Indicator |
Short name: | 3b-Proportion of patients with a hip fracture who were assessed for delirium following surgery |
METEOR identifier: | 780850 |
Registration status: | Australian Commission on Safety and Quality in Health Care, Standard 10/09/2023 |
Description: | Proportion of patients with a hip fracture who had an assessment for delirium following surgery. |
Indicator set: |
Collection and usage attributes | |
Population group age from: | Age 50 year and older |
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Computation description: | To be included in the numerator, an assessment of delirium must be undertaken following surgery and must include the use of a validated delirium diagnostic/assessment tool. There are a range of validated diagnostic/assessment tools available. Examples include:
The 4AT has been validated both for screening for cognitive impairment and delirium assessment. Administration of the 4AT meets the numerator criteria for this indicator and for Hip Fracture Clinical Care Standard: 1a- Proportion of patients with a hip fracture who were screened for cognitive impairment using a validated tool on presentation to hospital. The assessment must involve patients and/or their carer, asking if they have noticed any recent changes (within hours or days) in the patient’s behaviour or mental status (National Institute for Health and Clinical Excellence 2010). The clinician undertaking the assessment should also discuss the patient’s diagnosis of delirium with the patient and/or their carer. The diagnosis of delirium and who it has been discussed with should be documented in the patient’s medical record (National Institute for Health and Clinical Excellence 2010). |
Computation: | (Numerator ÷ denominator) x 100 |
Numerator: | Number of patients with a hip fracture who were assessed for delirium using a validated tool following hip fracture surgery. |
Denominator: | Number of patients with a hip fracture who had hip fracture surgery. |
Representational attributes | |
Representation class: | Percentage |
Data type: | Real |
Unit of measure: | Service event |
Format: | N[NN] |
Accountability attributes | |
Reporting requirements: | Hip Fracture Clinical Care Standard 2023 |
Organisation responsible for providing data: | Health Service Organisations |
Accountability: | Health Service Organisations |
Source and reference attributes | |
Submitting organisation: | Australian Commission on Safety and Quality in Health Care |
Reference documents: | Australian Commission on Safety and Quality in Health Care. Hip Fracture Clinical Care Standard. Sydney: ACSQHC; 2023. Australian Commission on Safety and Quality in Health Care. Delirium Clinical Care Standard. Sydney: ACSQHC; 2021. National Institute for Health and Clinical Excellence. Delirium: diagnosis, prevention and management. Clinical guideline 103. London: NICE, 2019. Tieges Z, Maclullich AM, Anand A, Brookes C, Cassarino M, O’connor M, et al. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. J Age Ageing. 2020. Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014 Jul;43(4):496–502. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941–948. Shi Q, Warren L, Saposnik G, Macdermid JC. Confusion assessment method: a systematic review and meta-analysis of diagnostic accuracy. Neuropsychiatr Dis Treat. 2013;9:1359–1370. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001 Jul;29(7):1370–1379. Marcantonio ER, Ngo LH, O'Connor M, Jones RN, Crane PK, Metzger ED, et al. 3D-CAM. Derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study. Ann Intern Med. 2014 Oct 21;161(8):554–561. Helfand BK, D'Aquila ML, Tabloski P, Erickson K, Yue J, Fong TG, et al. Detecting delirium: a systematic review of identification instruments for non‐ICU settings. J Am Geriatr Soc. 2020;69(2):547–555. Wong K, Tsang A, Liu B & Schwartz R. The Ontario Senior Friendly Hospital Strategy Delirium and Functional Decline Indicators. Toronto: Ontario Local Health Integration Network; 2012. |
Relational attributes | |
Related metadata references: |