2.50
Hdl Handle:
http://hdl.handle.net/10755/161200
Type:
Presentation
Title:
Psychometric Testing of a Delirium Assessment Tool (DAT) for Intubated Patients
Abstract:
Psychometric Testing of a Delirium Assessment Tool (DAT) for Intubated Patients
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Connelly, Lynne, PhD, RN
P.I. Institution Name:Benedictine College
Title:Nursing
Contact Address:14107 Independence St, Basehor, KS, 66007, USA
Contact Telephone:(913) 588-1657 (w)
Co-Authors:L.M. Connelly, School of Nursing, University of Kansas, Kansas City, KS; L.M. Connelly, M. Bollen, A. Kubo, Nursing, University of Kansas Hospital, Kansas City, KS; C. Goodyear-Burch, School of Allied Health, University of Kansas Hospital, Kansas City, KS
Delirium is a serious complication with three-fold increase in hospital death rates. Available instruments to screen for delirium were difficult to use on non-verbal patients or with ones with poor visual/motor function. An easy to use screening tool based on current evidence-based literature and a validated tool was clinically successful, but psychometric testing was needed. The purpose of this study was to test the psychometric properties of this screening tool for delirium in intubated adult intensive care patients. Methods: Prospective, instrument testing design was used. The DAT was developed based on the Intensive Care Delirium Screening Checklist and other literature and consisted of 4 subscales: Altered level of consciousness, inattention, psychomotor agitation, and psychosis (hallucinations, delusions). Each is rated as present or absent. A patient is considered to be positive if 2 or more of the 4 areas are present; leading to physician referral. Results: Out of 346 assessments, 202 assessments (58%) were done on 164 intubated patients in a Medical ICU. This sample consisted of 130 male patients and 72 females with mean age of 52 (range 19-83). Typical diagnoses were acute respiratory failure, sepsis, and liver failure. Of the 164 intubated patients screened, 38 (23%) were assessed as positive, indicating the need for referral to the physician. Sensitivity (true positives with delirium orders) was 95% (36/38) with 95% CI=86-99% and specificity (true negatives) was 99% (162/164). Inter-rater reliability for the DAT was 100% between two nurse raters with only 6 disagreements on sub-items. The DAT picked up one more patient with delirium than the original instrument (97% agreement). Although further testing is needed, this new screening tool shows promise in being an effective, useable instrument. Staff is able to learn how to use the tool quickly and documentation has improved from 8% to 97%.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePsychometric Testing of a Delirium Assessment Tool (DAT) for Intubated Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161200-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Psychometric Testing of a Delirium Assessment Tool (DAT) for Intubated Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Connelly, Lynne, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Benedictine College</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">14107 Independence St, Basehor, KS, 66007, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(913) 588-1657 (w)</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lconnelly@kumc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L.M. Connelly, School of Nursing, University of Kansas, Kansas City, KS; L.M. Connelly, M. Bollen, A. Kubo, Nursing, University of Kansas Hospital, Kansas City, KS; C. Goodyear-Burch, School of Allied Health, University of Kansas Hospital, Kansas City, KS</td></tr><tr><td colspan="2" class="item-abstract">Delirium is a serious complication with three-fold increase in hospital death rates. Available instruments to screen for delirium were difficult to use on non-verbal patients or with ones with poor visual/motor function. An easy to use screening tool based on current evidence-based literature and a validated tool was clinically successful, but psychometric testing was needed. The purpose of this study was to test the psychometric properties of this screening tool for delirium in intubated adult intensive care patients. Methods: Prospective, instrument testing design was used. The DAT was developed based on the Intensive Care Delirium Screening Checklist and other literature and consisted of 4 subscales: Altered level of consciousness, inattention, psychomotor agitation, and psychosis (hallucinations, delusions). Each is rated as present or absent. A patient is considered to be positive if 2 or more of the 4 areas are present; leading to physician referral. Results: Out of 346 assessments, 202 assessments (58%) were done on 164 intubated patients in a Medical ICU. This sample consisted of 130 male patients and 72 females with mean age of 52 (range 19-83). Typical diagnoses were acute respiratory failure, sepsis, and liver failure. Of the 164 intubated patients screened, 38 (23%) were assessed as positive, indicating the need for referral to the physician. Sensitivity (true positives with delirium orders) was 95% (36/38) with 95% CI=86-99% and specificity (true negatives) was 99% (162/164). Inter-rater reliability for the DAT was 100% between two nurse raters with only 6 disagreements on sub-items. The DAT picked up one more patient with delirium than the original instrument (97% agreement). Although further testing is needed, this new screening tool shows promise in being an effective, useable instrument. Staff is able to learn how to use the tool quickly and documentation has improved from 8% to 97%.</td></tr></table>en_GB
dc.date.available2011-10-26T23:17:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:17:31Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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