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Delirium clinical care standard indicators: 5c-Proportion of patients with delirium who have had a fall or a pressure injury during their hospital stay

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 5c-Proportion of patients with delirium who have had a fall or a pressure injury during their hospital stay
METeOR identifier:Help on this term628108
Registration status:Help on this termHealth, Standard 12/09/2016
Description:Help on this term

Proportion of patients with delirium who have had a fall or a pressure injury during their hospital stay.

Rationale:Help on this term

Patients with delirium are at greater risk of adverse events, including falls (Travers et al. 2013; Inouye et al. 2014; Maher & Almeida 2002) and pressure injuries (Inouye et al. 2014; Maher & Almeida 2002).

Indicator set:Help on this termClinical care standard indicators: delirium Health, Standard 12/09/2016
Outcome area:Help on this termPreventing falls and pressure injuries Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

The numerator includes patients with delirium who have had a fall and/or a pressure injury recorded in the hospital’s incident reporting and management system.

Only count Stage II, III or IV pressure injuries, or unstageable, or suspected deep tissue injury (NPUAP & EPUAP 2009; Australian Wound Management Association 2012):

  • Stage II pressure injury: partial thickness skin loss (partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, with slough).
  • Stage III pressure injury: full thickness skin loss (subcutaneous fat may be visible but bone, tendon or muscle are not fully exposed).
  • Stage IV pressure injury: full thickness tissue loss (full thickness tissue loss with exposed bone, tendon or muscle)
  • Suspected deep tissue injury: depth unknown (purple or maroon localised area or discoloured, intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear).
  • Unstageable pressure injury: depth unknown (full thickness tissue loss in which the base of the pressure injury is covered by slough (yellow, tan, grey, green or brown) and/or eschar (tan, brown or black) in the presuure injury bed).

Only count falls and/or pressure injuries noted as occurring during the hospital stay.

All patients with delirium are included in both the numerator and the denominator, not only those where Hospital service—care type, code N[N] = 1 Acute care.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with delirium who have had a fall or a pressure injury during their hospital stay.

Denominator:Help on this term

Number of patients with delirium.

Comments:Help on this term

This indicator has been sourced from the Key principles for care of confused hospitalised older persons (ACI 2014).

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term


Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

ACI (Agency for Clinical Innovation) 2014. Key Principles for care of confused hospitalised older persons. Sydney: ACI.

Australian Wound Management Association 2012. Pan Pacific clinical practice guideline for the prevention and management of pressure injury, WA: Cambridge Media. Viewed 7 August 2016,

Inouye S, Westendorp R & Saczynski J 2014. Delirium in elderly people. The Lancet. 383(9920):911-22.

Maher S & Almeida O 2002. Delirium in the elderly another medical emergency. Current Therapeutics March 39-45.

NPUAP (National Pressure Ulcer Advisory Panel) & EPUAP (European Pressure Ulcer Advisory Panel) 2009. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: NPUAP.

Travers C, Byrne G, Pachana N, Klein K & Gray L 2013. Delirium in Australian hospitals: a prospective study. Current Gerontology and Geriatrics Research 2013:284780.

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