• Anna Porteous, Felicity Dewhurst, William Keith Gray, Paul Coulter, Ulka Karandikar, Rachel Kiltie, Lucy Lowery, Fiona MacCormick, Ann Paxton, Jonathan Pickard, Grace Rowley, Jennifer Vidrine, Rowan Walmsley, Kerry Waterfield, Donna Weiand, and Eleanor Grogan.
• Consultant in Palliative Medicine, South Tyneside NHS Foundation Trust, England, UK.
• Int J Palliat Nurs. 2016 Sep 2; 22 (9): 444-447.

ObjectivesThe UK National Institute for Health and Care Excellence (NICE) indicate that palliative care patients are at high risk of delirium and should be screened for it using the short confusion assessment method (short CAM). This study aimed to assess the perceptions of the short CAM for delirium screening amongst health-care workers in specialist palliative care inpatient units (SPCUs) and to investigate its use as a screening instrument.MethodsPatients in 5 SPCUs in the North East of England were screened for delirium using the short CAM and a staff survey assessed the acceptability of the short-CAM in this setting.ResultsOf the 63 staff surveyed, 79.4% felt screening for delirium was important and 59.3% found the short CAM 'not at all' burdensome to complete. However, only 40.7% felt that the short-CAM often accurately reflected patients' conditions and none felt it always accurately reflected patients' condition. Of 298 patients screened, 20% screened positive on the short CAM. Malignant and intra-cerebral diseases were significant independent predictors of a positive screen. Hospice length of stay and in-hospice mortality were higher in those with a positive result (66.7%) than in those without (38.2%).ConclusionsHealth professionals deem delirium screening to be important in SPCUs, but may not support routine use of the short CAM. This could reflect a limited perceived impact on care and lack of confidence in this tool to reflect a complex patient group.

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