Translation, retranslation and validation of the Dutch Confusion Assessment Method for the Intensive Care Unit

Vreeswijk, Ralph; Honing, Marina L. H.; Баккер, К.; Spronk, Peter E.; Man, Tjarda de; Jonghe, Jos de; Kalisvaart, Kees J.

doi:10.1186/cc6736

Cited by 9 publications

(9 citation statements)

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“…Because training was comprehensive and did not essentially differ between centers, a possible explanation for our results may be that bedside nurses lack motivation to perform the CAM-ICU correctly if it is not standard to always evaluate the result in the treatment of their patients. However, even in centers where the test results were always part of the standard evaluation by the intensivist, sensitivity was still substantially lower (50%-71%) than in the original validation studies (97%-100%) (16,(20)(21)(22).…”

Section: Discussionmentioning

confidence: 74%

“…The CAM-ICU in daily practice showed thus not quite as good test characteristics as presented in the original validation studies (16,(20)(21)(22), where a limited number of specially trained research nurses performed the test and some categories of ICU patients were excluded (e.g., patients with a neurologic disorder). The discrepancy in findings may also be caused by inadequate training or by incomplete implementation of the CAM-ICU in daily routine.…”

Section: Discussionmentioning

confidence: 92%

“…This study is the largest study on this topic, with 181 included noncomatose patients from 10 different ICUs. Earlier CAM-ICU validation studies (16,(20)(21)(22) included fewer patients (range, 30-129) and all had a single-center design, potentially hampering external validity. Most importantly, in all previous studies, assessments were performed by a limited number of research nurses, whereas our investigation is an evaluation of daily life.…”

Section: Discussionmentioning

confidence: 99%

“…The CAM-ICU showed high sensitivity (range, 97%-100%) and specificity (range, 89%-100%) in several validation studies (16,(20)(21)(22). It should, however, be noted that all these investigations were performed in research settings (16,(20)(21)(22), which may differ from day-to-day critical care (23). Test characteristics of the CAM-ICU as performed by bedside ICU nurses are unknown.…”

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

“…Several medical organizations, including the Society of Critical Care Medicine and the American Psychiatric Association, advise standard screening for delirium in critically ill patients (12,19). The CAM-ICU showed high sensitivity (range, 97%-100%) and specificity (range, 89%-100%) in several validation studies (16,(20)(21)(22). It should, however, be noted that all these investigations were performed in research settings (16,(20)(21)(22), which may differ from day-to-day critical care (23).…”

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

See 4 more Smart Citations

Routine Use of the Confusion Assessment Method for the Intensive Care Unit

Eijk

Boogaard²,

Marum³

et al. 2011

Am J Respir Crit Care Med

258

186

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

See 3 more Smart Citations

Routine Use of the Confusion Assessment Method for the Intensive Care Unit

Eijk

Boogaard²,

Marum³

et al. 2011

Am J Respir Crit Care Med

258

186

View full text Add to dashboard Cite

show abstract

Delier tijdens kritische ziekte alleen maar lastig?

Riekerk¹,

Vreeswijk²,

Toornvliet³

et al. 2008

CRCA

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Occurrence of delirium is severely underestimated in the ICU during daily care

et al. 2009

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Objective: Delirium is associated with prolonged intensive care unit (ICU) stay and higher mortality. Therefore, the recognition of delirium is important. We investigated whether intensivists and ICU nurses could clinically identify the presence of delirium in ICU patients during daily care. Methods: All ICU patients in a 3-month period who stayed for more than 48 h were screened daily for delirium by attending intensivists and ICU nurses. Patients were screened independently for delirium by a trained group of ICU nurses who were not involved in the daily care of the patients under study. The Confusion Assessment Method for the ICU (CAM-ICU) was used as a validated screening instrument for delirium. Values are expressed as median and interquartile range (IQR; P25-P75). Results: During the study period, 46 patients (30 male, 16 female), median age 73 years (IQR = 64-80), with an ICU stay of 6 days (range 4-11) were evaluated. CAM-ICU scores were obtained during 425 patient days. Considering the CAM-ICU as the reference standard, delirium occurred in 50% of the patients with a duration of 3 days (range 1-9). Days with delirium were poorly recognized by doctors (sensitivity 28.0%; specificity 100%) and ICU nurses (sensitivity 34.8%; specificity 98.3%). Recognition did not differ between hypoactive or active status of the patients involved. Conclusion: Delirium is severely under recognized in the ICU by intensivists and ICU nurses in daily care. More attention should be paid to the implementation of a validated delirium-screening instrument during daily ICU care.

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Translation, retranslation and validation of the Dutch Confusion Assessment Method for the Intensive Care Unit

Cited by 9 publications

References 0 publications

Routine Use of the Confusion Assessment Method for the Intensive Care Unit

Routine Use of the Confusion Assessment Method for the Intensive Care Unit

Delier tijdens kritische ziekte alleen maar lastig?

Occurrence of delirium is severely underestimated in the ICU during daily care

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