Can the Delirium Observation Scale (DOS) Be Used to Screen for Delirium in the ICU? (S804)

Abstract

•List the incidence of delirium in ICU patients.•Understand the importance of screening for delirium. Delirium is common in hospice and palliative care patients and has serious immediate and long-term consequences, especially when left untreated. Quality of life and morbidity is improved treatment; unfortunately, delirium is often not recognized. The Delirium Observation Screening Scale (DOS) is a screening tool which merely requires observation of patients, with no specific cognitive testing, making it ideal for routine use by busy nurses. This study aims to determine the ability of the DOS to accurately screen older ICU patients for delirium. The effectiveness of the DOS was assessed by comparing its results to those of a validated delirium diagnostic tool, the Delirium Rating Scale-Revised-98 (DRS-R-98). Participants were patients admitted to the surgical ICU. Intubated and non-English speaking patients were excluded. Nurses working in the SNICU recorded DOS scores in the electronic medical records of all patients over the age of 65. A trained medical student administered the DRS-R-98 and collected data from consented patients within 24 hours of the nurse-recorded DOS score. The results of the DOS were then compared with those of the DRS-R-98. 61 assessments of 46 patients were conducted. Comparing the results of the DOS to the results of the previously validated DRS-R-98, the sensitivity of the DOS was 84.6% and the specificity of the DOS was 93.8%. The DOS is a sensitive and specific test for the diagnosis of delirium in ICU patients over the age of 65. Its accuracy, coupled with its usability, makes it an effective tool for busy nurses to use to detect delirium while engaging in routine patient care.