Impact on delirium detection of using a sensitive instrument integrated into clinical practice

Early symptoms of delirium often go unnoticed. The Nursing Delirium Screening Scale (Nu-DESC) is a recently developed short, accurate and sensitive 24-h screening instrument. The Nu-DESC is more sensitive than the instrument from which it was derived, the Confusion Rating Scale (CRS). This study exa...

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Bibliographic Details
Published in:General hospital psychiatry 2005-05, Vol.27 (3), p.194-199
Main Authors: Gaudreau, Jean-David, Gagnon, Pierre, Harel, François, Roy, Marc-André
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Delirium
Delirium - diagnosis
Early detection
Early Diagnosis
Female
Humans
Male
Mass Screening - instrumentation
Medical Oncology
Medical sciences
Middle Aged
Oncology
Psychology. Psychoanalysis. Psychiatry
Psychometrics. Diagnostic aid systems
Psychopathology. Psychiatry
Quebec
Sensitivity and Specificity
Sensitivity of screening
Techniques and methods
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Summary:Early symptoms of delirium often go unnoticed. The Nursing Delirium Screening Scale (Nu-DESC) is a recently developed short, accurate and sensitive 24-h screening instrument. The Nu-DESC is more sensitive than the instrument from which it was derived, the Confusion Rating Scale (CRS). This study examined the impact on delirium detection of using the Nu-DESC over the CRS in 134 consecutive oncology patients. Expected false-negative rate (FNR) reductions at different delirium prevalence rates when using the Nu-DESC compared to the CRS and the number needed to screen (NNS) by the Nu-DESC were calculated. Kaplan–Meier survival analyses were used to study Nu-DESC–CRS divergences in delirium status and length of delirium-free survival. Ninety-nine patients were negative for delirium according to both tests. Of the remaining 35 patients, 16 had identical Nu-DESC–CRS delirium status and delirium-free survival, whereas 19 were detected later by the CRS (mean, 4.8 days). Among the 19 patients, 6 were still CRS negative upon hospital discharge. Integrating a continuous and sensitive delirium assessment instrument into usual care can facilitate its recognition, since more cases of delirium are diagnosed and patients are detected earlier.
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2005.01.002