Delirium prevalence and delirium literacy across Italian hospital wards: a secondary analysis of data from the World Delirium Awareness Day 2023
Authors: Ornago Alice Margherita , Pinardi Elena , Okoye Chukwuma , Mazzola Paolo , Ferrara Maria Cristina , Finazzi Alberto , Nydahl Peter , von Haken Rebecca , Lindroth Heidi , Liu Keibun , Morandi Alessandro , Bellelli Giuseppe ,   National Collaborators, Goldberg Adela , Caplan Gideon , Hoffmann Magdalena , Nawa Ricardo Kenji , Silva Thiago , de Castro Roberta Esteves Vieira , Krewulak Karla , Mailhot Tanya , Fiest Kirsten , Oexenbull Marie , Pandya Tej , Papanikolaou Metaxia , Benbenishty Julie , Asheknazy Shelly , Gurjar Mohan , Timmons Suzanne , Chung Chi Ryang , Elhadi Muhammed , van den Boogaard Mark , Woien Hilde , Paulino Maria Carolina , Heras Gabi , Alhammad Abdullah M. , Markovic Dejan , Lau Yie Hui , Quinn Terry , Heras Gabi , Vich Carola Gimenez-Esparza , Jeitziner Marie-Madlen , Exl Matthias , Blackwood Bronagh , Oh E. , Fuchita M. , Maya K. , Smith K. , Brynes T. , Palakashappa J. , Cotton S. , Hetland B. , McAndrew N. , Mulkey M. ,   Italian Participating Clinicians, Agostino Clara , Alonso Yanely Sarduy , Bandera Ilaria , Ceroni Costanza Berti , Binda Filippo , Bo Mario , Bragaglia Maria-Cristina , Brunetti Enrico , Bucciarelli Luca , Cacciatore Stefano , Cadei Monica , Casella Gianni , Cavara Martina , Chiusolo Incoronata , Ciambrone Antonio , Clericò Giulia , Coin Alessandra , Colacicco Marika , Di Risio Alessandro , Favero Valter , Fazio Paola Claudia , Filippelli Rosa , Francioni Luigi , Galazzi Alessandro , Gamba Barbara , Gava Giordana , Gentile Simona , Giovannini Emma , Guadi Barbara , Isidro Mary Jane , Iurlaro Angela , Legierska Maria , LoMele Silvia , Maniscalco Vitalba , Marca Michela , Martella Valentina , Massaro Claudia , Matacena Marialaura , Merli Elena , Migliorino Giuseppina , Monesi Alessandro , Nativio Valeria , Principato Giulia , Quattrocchi Daniela , Ercolini Daniela Perelli , Ercolini Sabina Perelli , Paternoster Francesca , Pilati Lorenzo , Pittarello Samanta , Presta Roberto , Radeanu Daniela Petronela , Ratto Giulia , Recupero Carla , Reggiani Alessandro , Reggiani Anna Rita , Risoli Antonella , Romagnoli Barbara , Romana Francesca Ruma , Ruggeri Loretta , Salis Francesco , Trotta Elena , Tupputi Salvatore , Varatta Edoardo , Viani Valentina , Zazzara Maria Beatrice 
Published: July 2024

Abstract
Purpose
Delirium, a common medical emergency among hospitalized patients, requires effective detection and management protocols. This study aims to evaluate the delirium point prevalence and its management across Italian hospitals, categorized by delirium literacy levels. Additionally, it seeks to identify prevailing barriers and future priorities in delirium practice and research.

Methods
We analyzed data from World Delirium Awareness Day (WDAD) on March 15th, 2023, collected by participating clinicians in Italian hospitals. High delirium literacy (HL) was determined based on the use of validated delirium assessment tools and the presence of a written protocol for delirium management. Conversely, low delirium literacy (LL) was determined by meeting only one or neither of these criteria.

Results
Fifty-eight hospital wards participated in the survey, with 25 (43.1%) classified as HL. The overall reported point prevalence of delirium was found to be approximately 10%. Notably, the reported prevalence was twice as high in the HL group compared to the LL group. Despite minimal differences compared to the other group, the HL group demonstrated greater adherence to appropriate delirium management strategies, encompassing both non-pharmacological and pharmacological strategies. Critical gaps in delirium care emerged, including suboptimal management practices, barriers to implementing evidence-based strategies, and insufficient awareness and training among professionals.

Conclusion
The study highlights the suboptimal identification and management of delirium among Italian hospitals, emphasizing the necessity of enhancing awareness and implementing evidence-based strategies. Addressing these shortcomings is crucial for optimizing delirium care, improving patient outcomes, and mitigating the burden of delirium in hospital settings.