Provider Resources

The Delirium Observation Screening Scale (DOSS)

The University of Iowa Hospitals and Clinics selected the DOSS for nurses to use for screening patients for delirium. It is quick and easy to use. Prior research and our own studies suggest this is a fairly accurate tool. It has excellent sensitivity. Specificity is lower. However, those who screen positive for delirium on this scale typically have subsyndromal delirium (delirium symptoms that do not meet full diagnostic criteria for delirium).

The original study validating the DOSS is available here

IGEC faculty publications on the validity of the DOSS in hospitalized and hospice patients are available here:

Validation in hospitalized patients

Validation in hospice patients

Delirium: A Guide for Families

This guide provides an overview of the signs and symptoms, risk factors, and treatment of delirium. It is meant to be shared with family members to help them identify delirium in their loved ones, and to help them understand delirium and its treatment if their loved one is delirious. It is written in reader-friendly language appropriate for those with limited health literacy, and is available in both English and Spanish.

English

Spanish

Delirium Order Set

An order set for health care providers that was created and incorporated into the electronic medical record system (Epic) is available upon request. Contact Dr. Ryan Carnahan, PharmD, for additional information at ryan-carnahan@uiowa.edu.

Delirium Prediction Model

IGEC faculty are working toward publication of research predicting delirium in hospitalized patients. Depending on the information used, they were able to correctly classify whether a patient was at risk of delirium in 80-90% of patients. We are interested in evaluating this model in other hospitals. For more information about the prediction model, please contact Dr. Ryan Carnahan, PharmD, at ryan-carnahan@uiowa.edu.

Online Lectures about Delirium

Several lectures that include discussion on delirium can be found in our GeriaCast archives, with new lectures added when they are available.

Assessment and Interventions for Delirium

Chemobrain: It's Not All in Your Head

Delirium: Medication Decision-Making in Prevention and Management

Symptom Management and Care of the Dying Patient

*Please note that access to these resources requires a free user account. Register for your account here.

Virtual Patients

The IGEC designed a series of "virtual patient" simulations (GeriaSims), including one on delirium in older adults. This module offers the opportunity to virtually diagnose and treat a patient with delirium.

Delirium

*Please note that access to this resource requires a free user account. Register for your account here

Movie Trailers

IGEC faculty created several "teaching moment" movie trailers, including one on delirium. This brief summary can serve as an effective introduction to delirium.

Delirium GeriaTrailer

*Please note that access to this resource requires a free user account. Register for your account here

Info-Connect

Info-Connect provides quick-reference materials on topics of key clinical importance.  A publication is available that describes symptoms associated with delirium, depression, and dementia.

The 3D's: Delirium, Depression, and Dementia

Improving Antipsychotic Appropriateness in Dementia Patients (IA-ADAPT)

The IA-ADAPT program focuses on improving care for people with dementia and behavioral or psychological symptoms. Delirium is a common cause of these symptoms in people with dementia. The program includes:

  • A series of brief lectures, including one on delirium.
  • Decision aids to assist in management of these symptoms – available as a mobile device application, laminated hard copies, or PDF documents.
    • One overviews screening and management of delirium.
    • Another provides a list of drugs that may cause delirium or behavioral and psychological symptoms. This includes a list of drugs with anticholinergic effects, which commonly contribute to cognitive impairment and delirium.
  • Written reviews on specific topics, including one on delirium management.
  • An "Ask the Expert" section that includes information based on a large number of questions received from providers. It also allows the submission of questions.

Find the program here

Family Resources

Delirium: A Guide for Families

This guide provides an overview of the signs and symptoms, risk factors, and treatment of delirium. It can help you identify delirium in your loved one. It can also help you understand delirium and its treatment if your loved one is delirious. The guide is available in both English and Spanish. Please click on the link to learn more about delirium.

English

Spanish