• Céline Gélinas, Mélanie Bérubé, Annie Chevrier, Brenda T Pun, E Wesley Ely, Yoanna Skrobik, and Juliana Barr.
• Céline Gélinas is associate professor at Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, and is a researcher at the Centre for Nursing Research of the Jewish General Hospital, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca.
• Crit Care Nurse. 2018 Feb 1; 38 (1): 384938-49.

BackgroundDelirium is highly prevalent in critically ill patients. Its detection with valid tools is crucial.ObjectiveTo analyze the development and psychometric properties of delirium assessment tools for critically ill adults.MethodsDatabases were searched to identify relevant studies. Inclusion criteria were English language, publication before January 2015, 30 or more patients, and patient population of critically ill adults (>18 years old). Search terms were delirium, scales, critically ill patients, adult, validity, and reliability. Thirty-six manuscripts were identified, encompassing 5 delirium assessment tools (Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Cognitive Test for Delirium, Delirium Detection Score, Intensive Care Delirium Screening Checklist (ICDSC), and Nursing Delirium Screening Scale). Two independent reviewers analyzed the psychometric properties of these tools by using a standardized scoring system (range, 0-20) to assess the tool development process, reliability, validity, feasibility, and implementation of each tool.ResultsPsychometric properties were very good for the CAM-ICU (19.6) and the ICDSC (19.2), moderate for the Nursing Delirium Screening Scale (13.6), low for the Delirium Detection Score (11.2), and very low for the Cognitive Test for Delirium (8.2).ConclusionsThe results indicate that the CAM-ICU and the ICDSC are the most valid and reliable delirium assessment tools for critically ill adults. Additional studies are needed to further validate these tools in critically ill patients with neurological disorders and those at various levels of sedation or consciousness.©2018 American Association of Critical-Care Nurses.

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