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INTENSIVE CARE DELIRIUM SCREENING CHECKLIST i)Complete once a shift before afternoon rounds or towards the end of your N shift ii) Score either 0 or 1 for each section: no more than 1 point per section
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How to fill out intensive care delirium screening
How to fill out intensive care delirium screening:
01
Start by gathering the necessary documentation, such as the intensive care delirium screening tool and a pen or pencil.
02
Review the screening tool to familiarize yourself with the format and the questions that need to be answered.
03
Begin by documenting the date and time of the screening.
04
Assess the patient's level of consciousness by observing their responsiveness to stimuli and documenting it appropriately on the screening tool.
05
Evaluate the patient's level of inattention by testing their ability to maintain focus and accurately respond to a series of questions or commands.
06
Assess the patient's level of disorientation by asking them simple questions about time, place, and person. Document their responses accordingly.
07
Evaluate the patient's memory by asking them to recall specific information or events that occurred during their time in the intensive care unit.
08
Observe for any psychomotor disturbances, such as restlessness, agitation, or hypoactivity, and document them on the screening tool.
09
Assess the patient's level of altered sleep-wake cycle by documenting any disruptions in their normal sleep pattern, such as frequent awakenings or excessive sleepiness during the day.
10
Finally, review all the recorded information on the screening tool, ensuring accuracy and completeness.
Who needs intensive care delirium screening:
01
Patients who are admitted to the intensive care unit (ICU) are at a higher risk of developing delirium compared to those in other healthcare settings.
02
Patients with certain risk factors, such as advanced age, pre-existing cognitive impairment, or multiple comorbidities, may have an increased likelihood of developing delirium while in the ICU.
03
Individuals who have experienced trauma or major surgery, especially those requiring sedation or prolonged mechanical ventilation, are also at an elevated risk of developing delirium.
04
Intensive care delirium screening should be considered for patients who exhibit signs or symptoms of delirium, including fluctuations in mental status, altered perception, disorientation, or impaired attention and memory.
05
Regular screening is also essential for patients who have a prolonged ICU stay, as delirium can have serious consequences on their overall prognosis and outcomes.
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