A Survey of Delirium Self-Reported Knowledge and Practices among Emergency Physicians in the United States
Anita Chary, Adriane Lesser, Sharon K. Inouye, Christopher R. Carpenter, Amy Stuck, Maura Kennedy
Abstract
Objective: This study aimed to evaluate United States emergency physicians’ self-reported knowledge and practices regarding the detection, prevention, and management of delirium, a common and deadly syndrome that disproportionately affects older emergency department (ED) patients. Knowledge and practices of the broader emergency physician community about these priority topics in geriatric emergency medicine are understudied. Design: Electronic self-administered online survey Setting: United States Participants: One-hundred ninety-seven emergency physicians of the American College of Emergency Physicians Emergency Medicine Practice Research Network Measures: Descriptive statistics were generated from survey responses. Results: Of 734 physicians in the research network who were sent the survey, 197 (27%) responded. Most respondents reported intermediate (46%) or advanced (46%) knowledge of delirium detection and management and intermediate (61%) or advanced (21%) knowledge of delirium prevention. Forty percent reported low concern or neutrality over discharging a patient with delirium from the ED. There was high variability in respondents’ perception about the prioritization of delirium in their EDs, and only 14% reported the ED where they worked had a protocol addressing delirium. Participants identified multiple challenges in diagnosing, preventing, and managing delirium, including the physical space and logistics of the emergency care environment (82%), challenges identifying delirium in patients with dementia (75%), and time constraints (64%). Most (69%) perceived utility in increased clinician education on delirium. Conclusions: Surveyed emergency physicians self-report a high knowledge of delirium detection and management, in contrast to prior research demonstrating low ED delirium detection rates. The variable institutional prioritization of delirium reported also does not align with that of geriatric emergency medicine experts and associations, suggesting a need for strategies to bridge this gap.