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Adult nursing
Staff training and the use of rapid, accurate and user-friendly tools for delirium screening could improve the diagnosis of delirium in the elderly referred to the emergency department
  1. Paolo Mazzola1,2,
  2. Valentina Spedale1
  1. 1 School of Medicine and Surgery, Universita degli Studi di Milano-Bicocca, Monza, Italy
  2. 2 Acute Geriatrics Unit, ASST di Monza, Monza, Italy
  1. Correspondence to Professor Paolo Mazzola, School of Medicine and Surgery, Universita degli Studi di Milano-Bicocca, Monza 20126, Italy; paolo.mazzola{at}

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Commentary on: Eagles D, Cheung WJ, Avlijas T, et al. Barriers and facilitators to nursing delirium screening in older emergency patients: a qualitative study using the theoretical domains framework. Age Ageing. 2022;51:afab256. doi: 10.1093/ageing/afab256.

Implications for practice and research

  • Non-screening and treatment of delirium reflects missed nursing care and exposes the patient to a higher mortality risk.

  • Future research should investigate the effects of staffing levels on missed nursing care in relation to delirium screening and treatment.


A total of 7%–17% of older adults who present to the emergency department (ED) experience delirium.1 Delirium results in higher mortality, longer hospital stays and higher likelihood of functional decline. Despite its potential implications, up to 25% of patients with unrecognised delirium are discharged from the ED, carrying a higher rate of mortality than those with an identified delirium.1 The implementation of a standardised nursing …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.