Evidence summary and application of delirium risk assessment and prevention in elderly patients in emergency non-intensive care settings
SUN Zanzan
YANG Liping
ZHU Liqun
XIE Min
ZHUANG Ruo
XU Lei
SUN Guofu
SHENG Yue
Abstract：Objective:To investigate the current application status of evidence on delirium risk assessment and prevention in elderly emergency department patients,to analyze the barriers and facilitators in evidence-based nursing practice,and provide a basis for the clinical translation of evidence.Methods:Using the Ottawa Model of Research Application as the theoretical framework,audit criteria and methods were developed based on best evidence.Barriers and facilitators to evidence implementation in clinical practice were analyzed from three aspects:evidence-based change,potential adopters,and practice environment,based on clinical audits and interviews with stakeholders.Results:A total of 22 pieces of evidence were included,leading to the formulation of 22 audit criteria.The audit results showed that compliance rates for 13 criteria were 0%,6 criteria had compliance rates below 60%,and the remaining 3 criteria had compliance rates above 60%.The evidence-based changes for delirium risk assessment and prevention were complex.Main barriers included:the relevant evidence not being integrated into routine nursing care in the emergency department;a lack of professional knowledge and skills among emergency healthcare staff regarding delirium risk assessment and prevention;numerous risk factors for delirium in elderly emergency patients;the complex emergency environment;a lack of standardized screening tools,assessment and prevention protocols,and systems;and low rates of delirium education.Key facilitators included:a well-established hospital evidence-based project management system,leadership support,strong willingness for change,and alignment of the changes with quality control management requirements of the healthcare system.Conclusions:There is a significant gap between the evidence on delirium risk assessment and prevention for elderly emergency patients and clinical practice.Analyzing the barriers and facilitators could help developing further improvement measures to promote the effective application of evidence.
Keywords：deliriumagedemergencypreventionaudit indicatorsbarriersfacilitatorsknowledge translationevidence-based nursing
Publication Date：2025-11-10
Online Publishing Date：2025-11-13(First online date of this platform, not the publication date of the document)
Pages：8( 3602-3609 )