Intensive and Critical Care Nursing
Volume 25, Issue 5 , Pages 242-249 , October 2009

Limitations and practicalities of CAM-ICU implementation, a delirium scoring system, in a Dutch intensive care unit

  • Bea Riekerk

      Affiliations

    • Departments of Intensive Care Medicine, Gelre Hospitals, location Lucas, Apeldoorn, The Netherlands
  • ,
  • Evert Jan Pen

      Affiliations

    • Departments of Intensive Care Medicine, Gelre Hospitals, location Lucas, Apeldoorn, The Netherlands
  • ,
  • José G.M. Hofhuis

      Affiliations

    • Departments of Intensive Care Medicine, Gelre Hospitals, location Lucas, Apeldoorn, The Netherlands
  • ,
  • Johannes H. Rommes

      Affiliations

    • Departments of Intensive Care Medicine, Gelre Hospitals, location Lucas, Apeldoorn, The Netherlands
  • ,
  • Marcus J. Schultz

      Affiliations

    • Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • HERMES Critical Care Group, The Netherlands
  • ,
  • Peter E. Spronk

      Affiliations

    • Departments of Intensive Care Medicine, Gelre Hospitals, location Lucas, Apeldoorn, The Netherlands
    • Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • HERMES Critical Care Group, The Netherlands
    • Corresponding Author InformationCorresponding author at: Department of ICU, Gelre Hospitals, Lukas site, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands. Tel.: +31 55 5818450.

,Accepted 5 April 2009.

References 

  1. Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med. 2001;27:859–864
  2. Csokasy J. Assessment of acute confusion: use of the NEECHAM Confusion Scale. Appl Nurs Res. 1999;12:51–55
  3. Curtis JR, Cook DJ, Wall RJ, Angus DC, Bion J, Kacmarek R, et al. Intensive care unit quality improvement: a “how-to” guide for the interdisciplinary team. Crit Care Med. 2006;34:211–218
  4. Devlin JW, Fong JJ, Fraser GL, Riker RR. Delirium assessment in the critically ill. Intensive Care Med. 2007;33:929–940
  5. Devlin JW, Fong JJ, Schumaker G, O’Connor H, Ruthazer R, Garpestad E. Use of a validated delirium assessment tool improves the ability of physicians to identify delirium in medical intensive care unit patients. Crit Care Med. 2007;35:2721–2724
  6. Diagnostic and statistical manual of mental disorders 1994. 4th ed. (DSM-IV). American Psychiatric Press 1994; Washington D.C.
  7. Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). JAMA. 2001;286:2703–2710
  8. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29:1370–1379
  9. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289:2983–2991
  10. Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291:1753–1762
  11. Ely EW, Stephens RK, Jackson JC, Thomason JW, Truman B, Gordon S, et al. Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: a survey of 912 healthcare professionals. Crit Care Med. 2004;32:106–112
  12. Francis J, Kapoor WN. Prognosis after hospital discharge of older medical patients with delirium. J Am Geriatr Soc. 1992;40:601–606
  13. Grol R. Personal paper. Beliefs and evidence in changing clinical practice. BMJ. 1997;315:418–421
  14. Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362:1225–1230
  15. Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics. 1996;37:533–546
  16. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. Ann Intern Med. 1990;113:941–948
  17. Inouye SK. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients. Am J Med. 1994;97:278–288
  18. Lipowski ZJ. Delirium (acute confusional states). JAMA. 1987;258;1789-1792
  19. Milbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, et al. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004;32:955–962
  20. Morandi A, Pandharipande P, Trabucchi M, Rozzini R, Mistraletti G, Trompeo AC, et al. Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients. Intensive Care Med. 2008;34:1907–1915
  21. Neelon VJ, Champagne MT, Carlson JR, Funk SG. The NEECHAM Confusion Scale: construction, validation, and clinical testing. Nurs Res. 1996;45:324–330
  22. Otter H, Martin J, Basell K, von Heymann C, Hein OV, Bollert P, et al. Validity and reliability of the DDS for severity of delirium in the ICU. Neurocrit Care. 2005;2:150–158
  23. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med. 2007;33:66–73
  24. Pandharipande P, Cotton BA, Shintani A, Thompson J, Costabile S, Truman PB, et al. Motoric subtypes of delirium in mechanically ventilated surgical and trauma intensive care unit patients. Intensive Care Med. 2007;33:1726–1731
  25. Pisani MA, Araujo KL, Van Ness PH, Zhang Y, Ely EW, Inouye SK. A research algorithm to improve detection of delirium in the intensive care unit. Crit Care. 2006;10:R121
  26. Pun BT, Gordon SM, Peterson JF, Shintani AK, Jackson JC, Foss J, et al. Large-scale implementation of sedation and delirium monitoring in the intensive care unit: a report from two medical centers. Crit Care Med. 2005;33:1199–1205
  27. Riekerk B, Vreeswijk R, Toornvliet A, Ely EW, Schultz MJ, Spronk PE. The implementation process of a delirium screening instrument in daily ICU care. Am J Resp Crit Care Med, 177:A635.
  28. Soja SL, Pandharipande PP, Fleming SB, Cotton BA, Miller LR, Weaver SG, et al. Implementation, reliability testing, and compliance monitoring of the Confusion Assessment Method for the Intensive Care Unit in trauma patients. Intensive Care Med. 2008;34:1263–1268
  29. Vreeswijk R, Toornvliet A, Honing M, Bakker K, de Man T, Daas G, et al. The translation, retranslation and validation of the Dutch Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care. 2007;12(Suppl. 2):515

PII: S0964-3397(09)00028-7

doi: 10.1016/j.iccn.2009.04.001

Intensive and Critical Care Nursing
Volume 25, Issue 5 , Pages 242-249 , October 2009