Nursing Delirium Screening Scale, a Tool for Early Detection of Delirium: Integrative Review

Abstract

Objetivo: compilar la evidencia disponible con el fin de analizar el contexto y uso de la escala de detección del delírium para enfermería (Nu-DESC, por sus siglas en inglés) en la detección temprana del delírium en pacientes adultos.

Método: búsqueda de artículos relevantes en bases de datos como Cinahl, Medline, Ovid, Scopus, Web of Science. Criterios de inclusión: artículos escritos en idioma inglés, español y portugués; publicaciones entre enero del 2013 y octubre del 2019. Los términos de búsqueda fueron: “nursing delirium screen”, “inpatient delirium screening” y “nursing assessment”. Se identificaron 23 artículos en los que se utilizó el instrumento Nu-DESC en diferentes contextos. Dos revisores de manera independiente realizaron la evaluación de los artículos utilizando la herramienta CASPe.

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 pharma-cological interventions, and coordinate interdisciplinary actions for diagnosis, especially in post-anesthetic care units.