This thesis is designed to improve understanding, recognition, prevention and management of delirium in hospitalised older patients with hip fracture. Delirium is a preventable neuropsychiatric disorder characterized with acute confusion, disorientation, global cognitive deficit and is multifactorial. Delirium is considered one of the most common post-operative complication in patients with hip fracture. Research suggests that one third of delirium episodes are preventable if the identified factors can be addressed. Early recognition is also considered a key aspect of delirium prevention and management. This thesis focuses on development and implementation of the intervention bundle to reduce incidence of delirium through improved delirium recognition. The systematic review of the literature was performed to investigate the effect of multicomponent interventions on incidence of delirium. Focus groups with multidisciplinary clinicians from orthopaedic were performed to understand their perceptions in relation to recognition, diagnosis and management of delirium. The barriers identified in the focus groups and the best practice evidence identified in the systematic review was used to develop the intervention bundle to improve delirium recognition and care. This thesis demonstrated that a well-considered intervention bundle only had a mixed impact on decreasing incidence of delirium. This project also highlighted the significance of aligning clinical service improvement goals with the wider goals of the organisation. We have formed international research collaboration (Australia, Europe and United States) based on this project. We are exploring the concept of machine learning for preoperative prediction of postoperative delirium in patients with hip fractures
