Delirium assessment in neuro‐critically ill patients: A validation study

Abstract

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Psychometric properties of the intensive care delirium screening checklist when used by bedside nurses in clinical practice: a prospective descriptive study

“…Since the ICDSC is used for delirium screening, the original cutoff of 4 remains a good threshold for use in daily ICU practice. The sensitivity is consistent with the validation studies conducted in the research settings (75-99.0%) [16,17,19], where a limited number of trained researchers administered the ICDSC. However, compared to the studies evaluated in daily practice (43-71.9%) [8,18,[20][21][22], sensitivity in our study was higher.…”

“…Although the ICDSC has been advised for delirium screening in the ICU, evidence about its test characteristics with different cutoffs and user-friendliness when performed by bedside nurses is inconsistent [3,8,14,16,17,[19][20][21][22] This study presents evidence to support the psychometric properties and user-friendliness of the ICDSC used by nurses in clinical practice. The ICDSC is able to make a good differentiation between patients with and without delirium as compared to the CAM-ICU as reference method.…”

“…Both tools are valid for delirium detection in ICU research settings. However, when CAM-ICU assessments were performed by nurses in clinical practice, the sensitivity of the tool is low which limits its use as a screening tool [15,16]. Moreover, some additional disadvantages have been identified including the fact that CAM-ICU ratings are based on observations at one time-point using additional tests (i.e.…”

“…The ICDSC with its good sensitivity (range, 64-99%, depending on the used cutoff values) and its continuous scoring system based on routine care observations, seems to be useful for delirium screening in daily practice [10,12,17]. Yet, lower sensitivity rates (range 43-47%) [15,18] have been reported, and inconsistencies regarding its optimal cutoff [16,17,19,20] and its use for screening and monitoring the severity of delirium in pragmatic ICU settings remain unclear [3,8,21,22]. Furthermore, the userfriendliness of the ICDSC for bedside nurses in monitoring ICU patientsa prerequisite for implementation in practice -is unexplored.…”

European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

“…Delirium scales such as the CAM‐ICU , the Intensive Care Delirium Screening Checklist or the Confusion Assessment Protocol may be useful to diagnose and monitor delirium in conscious and communicative patients (emerged from MCS; possibly MCS+ with intentional communication). However, in severely brain‐injured patients, data on delirium screening tools are sparse and likely to be confounded by sedation, consciousness and cognitive impairments.…”