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Nationally agreed Delirium Assessment tool – 4AT

May 15, 2024

Elderly patients have always been required to be assessed for Delirium on both admission and post-operatively, and there have always been many tools to do this.  However now it’s been nationally agreed that only the 4AT Delirium Assessment tool should be used from now on.  Not to be confused with the AMT (Abbreviated Mental Test) for use in assessing patients for Dementia.

What is 4AT?

  • Simple and short delirium detection tool designed for easy and effective clinical use.
  • It’s the most-validated delirium tool in literature with <27 diagnostic test accuracy in recent studies.
  • Proven in routine care, high completion rates and delirium detection at expected clinical rates.
  • To find out more information about 4AT visit their website ( https://www.the4at.com/s/4AT)

Where to use 4AT?

4AT should be used on all elderly patients on admission, this would be first used on ED or AMU and for any patients where delirium or cognitive impairment is suspected.

How do I access the 4AT form?

Colleagues can now access the 4AT form via Unity. To access the form please see our user guide: https://connect2.swbh.nhs.uk/4at-delirium-screening-unity-guide/

View the Effective Change Improvements page https://connect2.swbh.nhs.uk/governance/clinical-effectiveness/sharing-effective-change-improvements/ 

Please contact the Clinical Effectiveness team for more information