App-based protocol identifies delirium in hospitalized adults

App-based protocol ID's delirium in hospitalized adults

(HealthDay)—An app-directed protocol is feasible, brief, and accurate for diagnosing delirium among inpatients, according to a study published online Nov. 9 in the Annals of Internal Medicine.

Edward R. Marcantonio, M.D., from Harvard Medical School in Boston, and colleagues tested implementation of a brief app-directed in real-world practice compared with a research reference standard delirium (RSDA). Participants included 527 general medicine inpatients (35 percent with preexisting dementia). Enrolled patients underwent RSDA on two study days. An ultra-brief two-item screen (UB-2) for delirium was performed by certified nursing assistants (CNAs), while a two-step protocol, including the UB-2 followed by the 3-Minute Diagnostic Assessment for the Confusion Assessment Method for those with a positive screen, was performed by physicians and nurses.

The researchers found that delirium was diagnosed in 17 percent of RSDAs and in 22 percent of the patients. The UB-2 was administered by CNAs in a mean of 62 seconds, while the two-step protocols were administered in means of 104 and 106 seconds by nurses and physicians, respectively. The sensitivities for UB-2 were 88, 87, and 82 percent when administered by CNAs, nurses, and physicians, respectively, while specificities varied from 64 to 70 percent. The overall accuracy of the two-step protocol was 89 and 87 percent for nurses and physicians, respectively, with sensitivities and specificities of 65 and 63 percent and 93 and 91 percent, respectively. For moderate-to-severe delirium, the two-step protocol sensitivity was 78 percent.

"Our protocol can substantially improve identification with a low false-positive rate among vulnerable hospitalized adults," the authors write.

More information: Abstract/Full Text (subscription or payment may be required)

Journal information: Annals of Internal Medicine

Copyright © 2021 HealthDay. All rights reserved.

Citation: App-based protocol identifies delirium in hospitalized adults (2021, November 9) retrieved 2 December 2023 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Explore further

New method could help nurses spot delirium quickly


Feedback to editors