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Quality and Safety in the Literature: September 2022
  1. Anna Burke1,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  2. 2 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Anna Burke; amburke{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals.

Key points

  • Integration of a tablet computer-based delirium screening app into typical clinician workflow in two US hospitals was feasible, rapid and accurate and could be completed by certified nursing assistants, nurses and hospitalist physicians. Increased ease and clinician participation in delirium assessment may allow for greater delirium detection. Ann Intern Med. 9 November 2021.

  • A structured, daily, multicomponent delirium prevention intervention within German hospitals resulted in a significant reduction in rates of delirium and its duration in older patients undergoing elective, non-cardiac surgical procedures. JAMA Surgery. 15 December 2021.

  • A multifactorial fall prevention programme, implemented within UK care homes and focused on staff education and risk assessment, was cost-effective and resulted in a significantly reduced rate of falls within 90 days. BMJ. 12 November 2021.

Comparative implementation of a brief app-directed protocol for delirium identification by hospitalists, nurses, and nursing assistants: a cohort study

Ann Intern Med, 9 November 2021

The clinical syndrome of delirium is highly prevalent in hospitalised patients, affecting 3%–29% of all hospitalised adults and 22%–89% of elderly patients with dementia.1 Delirium is associated with worsened mortality, long-term cognitive impairment, prolonged hospital length of stay and recovery, and patient dementia.2–6 Early detection and non-pharmacological prevention lead to decreased hospital days, falls, costs and days of delirium.5–11 Tools such as the validated Confusion Assessment Method (CAM) identify patient risk factors for delirium.12 13 However, despite advances in recognition strategies, delirium frequently evades prompt detection.6 7 Furthermore, the predictive ability of many of these tools against a gold …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests NH and AG are employed by the United States Department of Veterans Affairs.

  • Provenance and peer review Commissioned; internally peer reviewed.