Indicator 2b: Proportion of patients who screen positive for cognitive impairment at admission who are assessed for delirium using a validated diagnostic tool Definitional attributes Some validated diagnostic for delirium include: Name: Proportion of patients who screen Confusion Assessment positive for cognitive impairment Method (CAM)2,3 at admission who are assessed for delirium using a validated Confusion Assessment Method (CAM-ICU)4 diagnostic tool. 3D-CAM.5 Rationale: Early diagnosis and prompt The assessment must involve treatment offers patients with delirium the best chance patients and/or their carer, asking of recovery.1 if they have noticed any recent changes (within hours or days) in Collection and attributes the patient’s behaviour or mental status.6 The clinician undertaking Computation: (Numerator ÷ denominator) x 100 the assessment should also discuss Numerator: Number of patients who screen the patient’s diagnosis with the positive for cognitive impairment at patient and/or their carer and admission who are assessed for document the diagnosis and who delirium a validated tool. it has been discussed with in the patient’s medical record.6 Numerator criteria: Inclusions Exclusions admission’ means within Nil ‘At 24 hours of admission to hospital. Denominator: Number of patients who screen This includes any time that the positive for cognitive impairment patient may have spent in the at admission. emergency department. positive for cognitive ‘Screen impairment’ means that a score was obtained for the patient on Collection and attributes the validated test for cognitive (continued) impairment used locally, and this score was indicative of cognitive Denominator impairment according to the criteria: Inclusions parameters set by the tool and positive for cognitive ‘Screen agreed locally. impairment’ means that a score was obtained for the patient on the validated test for cognitive See indicator 1b for a impairment used locally; and list of validated tests for this was indicative of cognitive cognitive impairment. impairment according to the
Indicator 2b: Proportion of patients who screen positive for cognitive impairment at admission who are assessed for delirium using a validated diagnostic tool Definitional attributes Name: Proportion of patients who screen positive for cognitive impairment at admission who are assessed for delirium using a validated diagnostic tool. Rationale: Early diagnosis and prompt treatment offers patients with delirium the best chance of recovery.1 Collection and attributes Computation: (Numerator ÷ denominator) x 100 Numerator: Number of patients who screen positive for cognitive impairment at admission who are assessed for delirium a validated tool. Numerator criteria: Inclusions ‘At admission’ means within 24 hours of admission to hospital. This includes any time that the patient may have spent in the emergency department. ‘Screen positive for cognitive impairment’ means that a score was obtained for the patient on the validated test for cognitive impairment used locally, and this score was indicative of cognitive impairment according to the parameters set by the tool and agreed locally. See indicator 1b for a list of validated tests for cognitive impairment. Some validated diagnostic for delirium include: Confusion Assessment Method (CAM)2,3 Confusion Assessment Method (CAM-ICU)4 3D-CAM.5 The assessment must involve patients and/or their carer, asking if they have noticed any recent changes (within hours or days) in the patient’s behaviour or mental status.6 The clinician undertaking the assessment should also discuss the patient’s diagnosis with the patient and/or their carer and document the diagnosis and who it has been discussed with in the patient’s medical record.6 Exclusions Nil Denominator: Number of patients who screen positive for cognitive impairment at admission. Collection and attributes (continued) Denominator criteria: Inclusions ‘Screen positive for cognitive impairment’ means that a score was obtained for the patient on the validated test for cognitive impairment used locally; and this was indicative of cognitive impairment according to the