Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

Céline Gélinas^{1

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7}, Mélanie Bérubé^{8

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14}, Brenda T Pun^{8

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14}, E Wesley Ely^{8

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14}, Yoanna Skrobik^{8

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14}, Juliana Barr^{8

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Affiliations

¹ Céline Gélinas is associate professor at Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, and is a researcher at the Centre for Nursing Research of the Jewish General Hospital, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca.
² Mélanie Bérubé is the trauma program coordinator and research coordinator for the Department of Nursing at the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada. She is pursuing doctorate studies at Ingram School of Nursing, McGill University. celine.gelinas@mcgill.ca.
³ Annie Chevrier is assistant director of the Bachelor of Nursing program and is a faculty lecturer in the undergraduate and graduate programs of Ingram School of Nursing, McGill University. She is a clinical associate for the medical mission and steering committee for diabetes care at the McGill University Health Centre. celine.gelinas@mcgill.ca.
⁴ Brenda T. Pun is an advanced practice nurse at Vanderbilt University Medical Center, Nashville, Tennessee. She is affiliated with the Geriatric Research Education and Clinical Center of the Veterans Affairs Tennessee Valley Healthcare System. celine.gelinas@mcgill.ca.
⁵ E. Wesley Ely is a professor of medicine at Vanderbilt University School of Medicine, Nashville, Tennessee, and Associate Director of Research for the Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC). celine.gelinas@mcgill.ca.
⁶ Yoanna Skrobik is an intensive care specialist at McGill University, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca.
⁷ Juliana Barr is an associate professor of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, and a staff anesthesiologist and intensivist, VA Palo Alto Health Care System, Palo Alto, California. celine.gelinas@mcgill.ca.
⁸ Céline Gélinas is associate professor at Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, and is a researcher at the Centre for Nursing Research of the Jewish General Hospital, Montreal, Quebec, Canada.
⁹ Mélanie Bérubé is the trauma program coordinator and research coordinator for the Department of Nursing at the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada. She is pursuing doctorate studies at Ingram School of Nursing, McGill University.
¹⁰ Annie Chevrier is assistant director of the Bachelor of Nursing program and is a faculty lecturer in the undergraduate and graduate programs of Ingram School of Nursing, McGill University. She is a clinical associate for the medical mission and steering committee for diabetes care at the McGill University Health Centre.
¹¹ Brenda T. Pun is an advanced practice nurse at Vanderbilt University Medical Center, Nashville, Tennessee. She is affiliated with the Geriatric Research Education and Clinical Center of the Veterans Affairs Tennessee Valley Healthcare System.
¹² E. Wesley Ely is a professor of medicine at Vanderbilt University School of Medicine, Nashville, Tennessee, and Associate Director of Research for the Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC).
¹³ Yoanna Skrobik is an intensive care specialist at McGill University, Montreal, Quebec, Canada.
¹⁴ Juliana Barr is an associate professor of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, and a staff anesthesiologist and intensivist, VA Palo Alto Health Care System, Palo Alto, California.

PMID: 29437077
DOI: 10.4037/ccn2018633

Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

Céline Gélinas et al. Crit Care Nurse. 2018 Feb.

. 2018 Feb;38(1):38-49.

doi: 10.4037/ccn2018633.

Authors

Affiliations

¹ Céline Gélinas is associate professor at Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, and is a researcher at the Centre for Nursing Research of the Jewish General Hospital, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca.
² Mélanie Bérubé is the trauma program coordinator and research coordinator for the Department of Nursing at the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada. She is pursuing doctorate studies at Ingram School of Nursing, McGill University. celine.gelinas@mcgill.ca.
³ Annie Chevrier is assistant director of the Bachelor of Nursing program and is a faculty lecturer in the undergraduate and graduate programs of Ingram School of Nursing, McGill University. She is a clinical associate for the medical mission and steering committee for diabetes care at the McGill University Health Centre. celine.gelinas@mcgill.ca.
⁴ Brenda T. Pun is an advanced practice nurse at Vanderbilt University Medical Center, Nashville, Tennessee. She is affiliated with the Geriatric Research Education and Clinical Center of the Veterans Affairs Tennessee Valley Healthcare System. celine.gelinas@mcgill.ca.
⁵ E. Wesley Ely is a professor of medicine at Vanderbilt University School of Medicine, Nashville, Tennessee, and Associate Director of Research for the Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC). celine.gelinas@mcgill.ca.
⁶ Yoanna Skrobik is an intensive care specialist at McGill University, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca.
⁷ Juliana Barr is an associate professor of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, and a staff anesthesiologist and intensivist, VA Palo Alto Health Care System, Palo Alto, California. celine.gelinas@mcgill.ca.
⁸ Céline Gélinas is associate professor at Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, and is a researcher at the Centre for Nursing Research of the Jewish General Hospital, Montreal, Quebec, Canada.
⁹ Mélanie Bérubé is the trauma program coordinator and research coordinator for the Department of Nursing at the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada. She is pursuing doctorate studies at Ingram School of Nursing, McGill University.
¹⁰ Annie Chevrier is assistant director of the Bachelor of Nursing program and is a faculty lecturer in the undergraduate and graduate programs of Ingram School of Nursing, McGill University. She is a clinical associate for the medical mission and steering committee for diabetes care at the McGill University Health Centre.
¹¹ Brenda T. Pun is an advanced practice nurse at Vanderbilt University Medical Center, Nashville, Tennessee. She is affiliated with the Geriatric Research Education and Clinical Center of the Veterans Affairs Tennessee Valley Healthcare System.
¹² E. Wesley Ely is a professor of medicine at Vanderbilt University School of Medicine, Nashville, Tennessee, and Associate Director of Research for the Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC).
¹³ Yoanna Skrobik is an intensive care specialist at McGill University, Montreal, Quebec, Canada.
¹⁴ Juliana Barr is an associate professor of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, and a staff anesthesiologist and intensivist, VA Palo Alto Health Care System, Palo Alto, California.

PMID: 29437077
DOI: 10.4037/ccn2018633

Abstract

Background: Delirium is highly prevalent in critically ill patients. Its detection with valid tools is crucial.

Objective: To analyze the development and psychometric properties of delirium assessment tools for critically ill adults.

Methods: Databases were searched to identify relevant studies. Inclusion criteria were English language, publication before January 2015, 30 or more patients, and patient population of critically ill adults (>18 years old). Search terms were delirium, scales, critically ill patients, adult, validity, and reliability. Thirty-six manuscripts were identified, encompassing 5 delirium assessment tools (Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Cognitive Test for Delirium, Delirium Detection Score, Intensive Care Delirium Screening Checklist (ICDSC), and Nursing Delirium Screening Scale). Two independent reviewers analyzed the psychometric properties of these tools by using a standardized scoring system (range, 0-20) to assess the tool development process, reliability, validity, feasibility, and implementation of each tool.

Results: Psychometric properties were very good for the CAM-ICU (19.6) and the ICDSC (19.2), moderate for the Nursing Delirium Screening Scale (13.6), low for the Delirium Detection Score (11.2), and very low for the Cognitive Test for Delirium (8.2).

Conclusions: The results indicate that the CAM-ICU and the ICDSC are the most valid and reliable delirium assessment tools for critically ill adults. Additional studies are needed to further validate these tools in critically ill patients with neurological disorders and those at various levels of sedation or consciousness.

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Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

Affiliations

Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical