{"id":8434,"date":"2025-02-03T09:25:51","date_gmt":"2025-02-03T09:25:51","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=8434"},"modified":"2025-06-20T08:41:32","modified_gmt":"2025-06-20T07:41:32","slug":"early-screening-for-confusion-and-vitamin-d-deficiency-in-elderly-hip-fracture-patients-a-quality-improvement-initiative-to-mitigate-the-risk-of-postoperative-delirium-2024","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2025\/02\/03\/early-screening-for-confusion-and-vitamin-d-deficiency-in-elderly-hip-fracture-patients-a-quality-improvement-initiative-to-mitigate-the-risk-of-postoperative-delirium-2024\/","title":{"rendered":"Early Screening for Confusion and Vitamin D Deficiency in Elderly Hip Fracture Patients: A Quality Improvement Initiative to Mitigate the Risk of Postoperative Delirium (2024)"},"content":{"rendered":"\n

Type of publication:<\/strong><\/p>\n\n\n\n

Journal article<\/p>\n\n\n\n

Author(s):<\/strong><\/p>\n\n\n\n

Younis, Zubair; *Gurukiran, Gurukiran; *Abdullah, Faliq; *Kumar, Sairam; Ford, David; Hamid, Muhammad A; Wani, Kubra Farooq.<\/p>\n\n\n\n

Citation:<\/strong><\/p>\n\n\n\n

Cureus. 16(12):e75099, 2024 Dec.<\/p>\n\n\n\n

Abstract:<\/strong><\/p>\n\n\n\n

Background Postoperative delirium (POD) is a common and debilitating complication in elderly hip fracture patients, associated with significant clinical and functional consequences. Early identification of risk factors, such as cognitive impairment and vitamin D deficiency, is essential to mitigate its impact. However, preoperative screening practices are often inconsistent. This quality improvement initiative aimed to assess and improve compliance with early confusion and vitamin D screening in elderly hip fracture patients, with the goal of facilitating timely interventions to reduce the risk of POD. Methods A two-cycle audit was conducted in the Trauma and Orthopaedics Department at Royal Shrewsbury Hospital. The first cycle (April-June 2023) assessed baseline compliance with confusion (Abbreviated Mental Test Score (AMTS)) and vitamin D screening within 24 hours of admission. Identified barriers informed an intervention consisting of educational sessions, visual prompts, and checklist integration. The second cycle (August-October 2023) evaluated the impact of these measures. Compliance rates, timing of
assessments, and prevalence of abnormal biochemical and cognitive screening results were analyzed using Fisher's exact test (p < 0.05). Results Baseline compliance with screening was 27 patients (27%) out of 100, with primary barriers including lack of awareness and logistical challenges. Post-intervention compliance improved significantly for 54 patients (52.4%) out of 103 (p = 0.0003). Screening timeliness also increased, with 45 patients (83.33%) out of 54 screenings completed within 24 hours in cycle 2 compared to 14 patients (51.85%) out of 27 in cycle 1 (p = 0.0039). Biochemical analysis revealed persistently high rates of vitamin D deficiency, underscoring the need for early detection. AMTS scores correlated with abnormal confusion screens but highlighted limitations in cognitive-only assessments. Conclusion This quality improvement (QI) initiative demonstrated the efficacy of targeted interventions in improving screening compliance for confusion and vitamin D deficiency in elderly hip fracture patients. The findings advocate for integrating proactive, dual-focused screening protocols into clinical workflows to address modifiable risk factors for POD. Future research should explore the long-term impact of such measures on POD incidence, recovery trajectories, and functional outcomes while emphasizing the need
for sustained adherence to screening protocols.<\/p>\n\n\n\n

Link to full-text<\/a> [open access - no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Journal article Author(s): Younis, Zubair; *Gurukiran, Gurukiran; *Abdullah, Faliq; *Kumar, Sairam; Ford, David; Hamid, Muhammad A; Wani, Kubra Farooq. Citation: Cureus. 16(12):e75099, 2024 Dec. Abstract: Background Postoperative delirium (POD) is a common and debilitating complication in elderly…<\/span><\/p>\n

Read more Early Screening for Confusion and Vitamin D Deficiency in Elderly Hip Fracture Patients: A Quality Improvement Initiative to Mitigate the Risk of Postoperative Delirium (2024)<\/span> ›<\/span><\/a><\/div>\n

<\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1001,200],"tags":[1050,1084,226,1002,937,994],"class_list":["post-8434","post","type-post","status-publish","format-standard","hentry","category-open-access","category-staff-publication","tag-1050","tag-delirium","tag-elderly-care","tag-gold-open-access","tag-hip-fracture","tag-trauma-and-orthopaedics"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8434","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=8434"}],"version-history":[{"count":2,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8434\/revisions"}],"predecessor-version":[{"id":8732,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8434\/revisions\/8732"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=8434"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=8434"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=8434"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}