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Confusion app

A project run in North Cumbria University Hospitals NHS Trust

Related themes

  • Improving training programmes and pathways
  • Mental health


Patients with cognitive impairment suffer from increased adverse events and mortality, and less than 50% of patients with cognitive impairment are identified in hospital. This project was set up to improve the number of cognitive assessments being carried out in hospital settings in order to potentially decrease the number of adverse events suffered by this patient group. Access to bedside information to assess and manage these patients would help reduce this burden and increase the awareness and knowledge of medical doctors’ in training.

Project objectives

  • Develop a smartphone app for Apple devices on the topic of confusion, based on delirium and dementia to act as a teaching aid and bedside reference guide that provides information on cognitive assessment methods, interactive sections, patient medication review assistance and example case studies
  • Improve cognitive assessment by trainees in line with the National Institute for Health and Care Excellence(NICE) guidelines on delirium and the national dementia strategy
  • Increase early recognition of cognitively impaired patients
  • Identify important points from medical history and examination
  • Fulfil curriculum outcomes for trainee doctors
  • Increase patient safety and clinical care
  • Scope and develop an equivalent app for the Android market.

Who was involved

Trainees were involved in creating the app content and a consultant supervisor oversaw the project. Initially an app developer and graphic designer were needed to support the development of the app. The hospital’s IT team also supported the project by installing the app onto the hospital tablet computers.


  • Successful installation of the app amongst peers across the country, the use of social media has allowed the app to spread virally particularly as cognitive impairment is currently a very topical issue.
  • Aided day to day work – all doctors, via questionnaire, reported the app was easy to use and the scenarios were helpful and demonstrated an improved knowledge of the topic after using the app.
  • Case study was made available to work through with certificate on completion that can be linked to the e-portfolio.
  • Over 2,000 downloads of the app – around 100 downloads per month.
  • Improved cognitive assessment across both geriatric and orthopaedic ward with confusion app available on the ward.

What they’ve said

“Really great, easy to use and certificate great for portfolio!” 


“Good news that Confusion app now available on android. Looking forward to trying it on the wards today.”

NHS staff via twitter

“This is excellent. Just downloaded and spread the word.” 

NHS staff via twitter

“Mobile apps are useful guides. Download @Confusion app…” 

Royal College of Physicians staff


Please look at the materials in the related documents section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects.
Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

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