Authors

Carmen Carrera Castro

Position

Enfermera y experta universitaria. Servicio de Cirugía General, Hospital Ernest Lluch Martín (SALUD) de Calatayud.

Contact address

Servicio de Cirugía General. Enfermería B. Hospital Ernest Lluch Martín (SALUD). C/ Carretera de Sagunto, 254. 50300 Calatayud (Zaragoza).

Contact email: ccarrera@salud.aragon.es

Abstract

Objective: to identify those diagnostic tools available in clinical practice for acknowledging delirium in critically ill patients, and to describe the principles they are based on.
Methodology: narrative review. The search was structured into two phases: the first one was conducted with PubMed, to locate the different­ diagnostic scales for delirium in critically ill patients, and the studies detailing said scales, using the following MeSH descriptors: delirium, psychiatric evaluation scales, Intensive Care Units, and free terms, such as the names of different scales. The second phase was conducted with the scientific search engines “Google Académico” and SCIRUS, conducting the same search strategy as with PubMed.
Results: five diagnostic scales for delirium in critically ill patients were found, as well as 27 original studies with detailed or complementary information about them.
Most of them are ruled by the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III/IV), through the observations of a previously trained observer. These are easily managed, economic, effective, with different structural designs, and clinical and research implementation.
Conclusions: all scales present good psychometric characteristics for acknowledging delirium at the Intensive Care Unit. The CAM-ICU has been the most supported diagnostic tool, in the research setting as well as in routine clinical practice. It is not necessary to develop new tools, but to refine the existing ones in order to improve the structural gaps and perfect the early acknowledgement of delirium in critically ill patients (with or without verbal communication).

Keywords:

Delirium; critically ill patient; assessment scales; Intensive Care Unit; mental healthMedical-surgical Nursing

Versión en Español

Título:

Escalas diagnósticas de reconocimiento del delírium en el paciente crítico