Context: Older people with cognitive impairment are at particular risk of developing delirium when unwell; but screening is not routine and delirium is under recognised, resulting in adverse outcomes. Delirium is preventable in a third of cases; therefore, spotting, treating and stopping delirium are priorities. Nurses are well placed to identify risk factors and signs of delirium and communicate them to the clinical team.1 Arguably, they should lead delirium prevention and management. A barrier to good care is lack of awareness and education about best practice. Hasemann et al describe a multimodal approach to delirium prevention and management using education, regular cognitive and delirium screening, targeted medication use, addressing risk factors and active management of delirium.