Iowa Geriatric Education Center (IGEC) faculty are involved in research and quality improvement activities to improve identification of and care for delirium. They helped support the University of Iowa Hospitals and Clinics (UIHC) Department of Nursing in implementing delirium screening, especially for patients age 65 and older. They found that more than 1 out of 5 patients in this age group show symptoms suggesting they may be delirious, as indicated by a positive result on a delirium screening tool, the Delirium Observation Screening Scale (DOSS). They have done work evaluating the validity of this screening tool in hospitalized patients, as well as in hospice patients. The DOSS is a quick and easy-to-use screening tool based on nurse observations of symptoms, and was found to be quite accurate. It classified more patients as delirious than were actually delirious, but those who were identified as delirious all had at least some symptoms of delirium. It missed very few people who were delirious. Delirium screening is important because research shows that delirium is often overlooked by nurses and other health care providers. This may lead to delays in treatment and worse outcomes.

IGEC faculty worked with providers at UIHC to develop a delirium order set to improve care for delirium, which is available for use in the electronic medical record system. They also developed an equation ("model"), using information on more than 13,000 patients, that predicts whether someone is likely to become delirious based on their medical conditions, laboratory results, and medications. The equation is able to predict who will have a positive result on the screening tool with good accuracy. It is used in UIHC units to show providers who is at risk of becoming delirious. This helps them know who should be watched more closely, and who might be at risk of problems such as falls.

Finally, IGEC faculty helped to create "Delirium: A Guide for Families." This is a reader-friendly document, available in both English and Spanish, that tells family members about signs and symptoms to look for that may suggest their loved one is delirious. Family members are often good at recognizing delirium because they know how the person usually acts. They can inform health care providers when they see these signs or symptoms. This guide also helps them know what to expect, and understand that delirium is usually a temporary condition that will get better.

IGEC faculty are interested in working with other health systems, hospitals, or care providers to help them improve identification of and care for delirium. They have given many educational presentations about delirium, and are open to providing this education to others. Several lectures on delirium from the Geriatric Lecture Series are archived and available for viewing.