Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings

Miranda, Fabian; Gonzalez, Francisco; Plana, Maria Nieves; Zamora, Javier; Quinn, Terry J; Seron, Pamela

doi:10.1002/14651858.cd013126.pub2

Cited by 6 publications

(4 citation statements)

References 115 publications

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“…There were 43 patients on a ventilator; 67.4% (n = 29) of those on a ventilator had a positive CAM-ICU result (see Figure 5). The project findings were consistent with several studies where the incidence of delirium was between 55% and 80% after implementing the CAM-ICU tool (Zhang et al, 2021;Pavone et al, 2020;Miranda et al, 2023). Such findings entail that implementing the CAM-ICU tool in the CCU may effectively assess delirium that will be left undetected without a delirium assessment tool.…”

Section: Impact Of the Cam-icu Tool On Delirium Detectionsupporting

confidence: 88%

“…The CAM-ICU tool is valid and demonstrates high interrater reliability with a κ = 0.79-0.96. Compared with a standard physician diagnosis of delirium, the CAM-ICU tool demonstrates sensitivity of 93% to 100% and specificity of 89% to 100% (Zhang et al, 2023;Miranda et al, 2023). The authors collaborated with the informatics department, intensivist, nursing, respiratory therapy, and worked with case management to deploy the CAM-ICU tool.…”

Section: Designmentioning

confidence: 99%

“…However, its impact on reducing LOS, health care utilization, and health care costs remains controversial (Miranda et al, 2023). Early detection of delirium using the CAM-ICU can potentially reduce the LOS (Spiegelberg et al, 2020).…”

mentioning

confidence: 99%

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Bringing Delirium to Light

Savino,

Vergara,

Ramos

et al. 2024

Professional Case Management

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Background: Delirium is a serious complication in patients in the critical care unit (CCU) that may lead to prolonged hospitalization if left undetected. The CCU at our hospital does not have a framework for determining delirium that could affect patient outcomes and discharge planning. Primary Practice Setting: CCU in a community hospital. Method: A posttest-only design was used for this study. We established a framework for the early assessment of delirium, educated and trained nurses to detect delirium, collaborated with the informatics department, intensivist, nursing, respiratory therapy and worked with case management to deploy the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). We used a one-tailed independent t test to determine the impact of CAM-ICU on length of stay (LOS). Cross-tabulation and chi-square tests were used to examine the impact of CAM-ICU tool on home care utilization between the intervention and comparison groups. Results: There was a 3.12% reduction in LOS after implementing the CAM-ICU tool. Also, a reduction in home care service utilization demonstrated statistical significance (p= .001) between the intervention group (62.5%; n= 177) and the comparison group (37.5%; n= 106). Implications for Case Management Practice: Case managers are essential in improving care transitions. Case managers need to become competent in understanding the implications of the CAM-ICU tool because of their relevant role in the multidisciplinary rounds as advocates to improve care transitions across the continuum of care. Case managers need to have an understanding on how to escalate when changes in the Richmond Agitation-Sedation Scale scores occur during the multidisciplinary rounds because it can affect care coordination throughout the hospital. Conclusions: Implementing the CAM-ICU decreased LOS, and reduced health care utilization. The early identification of patients with delirium can affect the outcomes of critically ill patients and entails multidisciplinary collaboration.

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Section: Impact Of the Cam-icu Tool On Delirium Detectionsupporting

confidence: 88%

Section: Designmentioning

confidence: 99%

See 1 more Smart Citation

Bringing Delirium to Light

Savino,

Vergara,

Ramos

et al. 2024

Professional Case Management

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“…Several delirium assessments have been developed for the ICU setting [13]. One of the most widely used methods, the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), is a rapid (approximately 2 minutes for administration), straightforward, and effective means for nursing staff to screen for delirium in the ICU [17,18]. First, patients are scored with the Richmond Agitation and Sedation Scale (RASS); if the level of arousal is greater than −4 (deep sedation), patients are assessed for delirium.…”

Section: Screening Toolsmentioning

confidence: 99%