Abstract
Objective: To analyze the context and use of the Nursing Delirium Screening Scale (Nu-DESC) for early detection of delirium in adult patients, compiling the available evidence. Method: Searching for relevant articles on databases such as Cinahl, Medline, Ovid, Scopus, and Web of Science. Inclusion criteria: Articles written in English, Spanish, and Portuguese, published between January 2013 and October 2019. Search terms: “nursing delirium screen,” “inpatient delirium screening,” and “nursing assessment.” We identified 23 articles in which the Nu-DESC was used. Two reviewers independently assessed the articles using the CASPe (Critical Appraisal Skills Program in Spanish) tool. Results: The Nu-DESC is employed in different contexts such as the adult intensive care unit (ICU), post-anesthetic care unit (PACU), palliative care unit, and hospitalization unit. It is more frequently used in the PACU with a more sensitive threshold (≥ 1); the test showed greater sensitivity of 54.5 % (95 % CI: 32.2–75.6) and specificity of 97.1 % (95 % CI: 95.3–98.4). Conclusion: The Nu-DESC facilitates the recognition of delirium episodes by the nursing team, makes care quicker and individualized for each patient, avoiding immediate pharmacological interventions, and coordinate interdisciplinary actions for diagnosis, especially in post-anesthetic care units.
Highlights
Delirium is a disruption of consciousness characterized by inattention and cognitive/perception alterations developed in a short period and fluctuating over time [1]
The use of Nursing Delirium Screening Scale (Nu-DESC) in different contexts such as the hospitalization unit, post-anesthetic care unit (PACU), intensive care units (ICU), and palliative care unit facilitated the early diagnosis of delirium due to its easy application, considering that many of the studies were descriptive or comparative with other diagnostic scales
The role that nursing plays in the timely diagnosis of delirium through validated scales becomes increasingly valuable, knowing that delirium is a predictor of death in the patient, and the use of these tools allows for its timely recognition [54]
Summary
Delirium is a disruption of consciousness characterized by inattention and cognitive/perception alterations developed in a short period (hours or days) and fluctuating over time [1]. Within the perceptual-cognitive sphere, it is vital to recognize delirium in time, avoiding short- and long-term side effects. Monitoring is essential for its prompt identification and treatment [2]. 60–80 % of all patients in intensive care units (ICU) develop this disorder. They may suffer other complications due to a lack of recognition, assessment, and treatment, the essential role nurses play in its identification and assessment for being by the patient’s bedside. Delirium detection facilitates treatment, minimizing its duration and possible side effects. Some possible reasons for this are little time, knowledge of this condition, and unavailability of feasible and reliable instruments for diagnosis
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