Non-pharmacological treatment of delirium

Measure Purpose: Treatment of delirium with non-pharmacologic measures before medications

The numerator: Patients who were treated initially with a non-pharmacological treatment*

*See specifications for additional details

is divided by

The denominator: All patients admitted to an inpatient facility and who were diagnosed with delirium, not present on admission

Exclusions are removed from the denominator for:

• Preexisting antipsychotic medication prescribed
• Drug intoxication or alcohol withdrawal
• Patient who is posing direct harm to self or others

Key Phrases

Key phrases you should document to meet this measure include:

• Patient treated with non-pharmacologic measures
• Patient evaluated for cognitive impairment, visual/hearing impairment, immobilization, removal of restraints, urinary catheter, dehydration, malnutrition, polypharmacy, high-risk medications, sleep deprivation, iatrogenic event, sedative-hypnotics, and acute illness.

Measure Calculation Example

Dr. Perez had 130 patients on her hospital service and 60 present to the ED that were diagnosed with delirium between January 1 and December 31 of the measurement year. This is the denominator. Eight patients were posing direct harm to self or others, 22 had preexisting antipsychotic medications prescribed, and three were experiencing alcohol withdrawal. These exceptions are removed from the denominator.

Of the remaining 157 patients, Dr. Perez treated 40 patients initially with a non-pharmacological treatment. This is the numerator.

Quality of care = 40/(190-33). Dr. Perez's has a score of 25% for this measure.