Screening for delirium in the intensive care unit using eDIS-ICU - A purpose-designed app: A pilot study

Sutt, A. L., Flaws, D., Gunn, H., Eeles, E., Lye, I., Irvine, L., Patterson, S., Bagshaw, T., O'Luanaigh, C., Tronstad, O., & Fraser, J. (2021). Screening for delirium in the intensive care unit using eDIS-ICU - A purpose-designed app: A pilot study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 34(6), 547–551. https://doi.org/10.1016/j.aucc.2020.12.008

Introduction: Delirium, a common complication of an intensive care unit (ICU) admission, is inconsistently diagnosed by clinicians. Current screening tools require specialist expertise and/or training. Some are time-consuming to administer, and reliability in routine clinical practice is questionable. An innovative app designed to enable efficient and sensitive screening for delirium without specialist training (eDIS-ICU) has recently been described. This pilot study compared the eDIS-ICU against the reference standard expert assessment using DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria and the Confusion Assessment Method for the ICU (CAM-ICU).

Methods: In this prospective, single-centre pilot study, a convenience sample of 29 ICU patients were recruited at a tertiary referral hospital between November 2018 and August 2019. After obtaining written consent, demographic and clinical data were collected, and the patients were screened for delirium using eDIS-ICU and CAM-ICU by two clinician researchers in random order. The patients were also assessed for presence of delirium independently by an expert clinician using a structured interview to diagnose as per DSM-V criteria. The results of screening and diagnosis were tabulated to allow comparison of screening tools against diagnosis; sensitivity and specificity of the tools were calculated.