Recognizing Acute Delirium As Part of Your Routine [RADAR]: a Validation Study

Overview

Journal BMC Nurs

Publisher Biomed Central

Specialty Medical Education

Date 2015 Apr 7

PMID 25844067

Citations 22

Authors

Philippe Voyer

Nathalie Champoux

Johanne Desrosiers

Philippe Landreville

Jane McCusker

Johanne Monette

Maryse Savoie

Sylvie Richard

Pierre-Hugues Carmichael

Affiliations

Soon will be listed here.

Abstract

Background: Although detection of delirium using the current tools is excellent in research settings, in routine clinical practice, this is not the case. Together with nursing staff, we developed a screening tool (RADAR) to address certain limitations of existing tools, notably administration time, ease-of-use and generalizability. The purpose of this study was not only to evaluate the validity and reliability of RADAR but also to gauge its acceptability among the nursing staff in two different clinical settings.

Methods: This was a validation study conducted on three units of an acute care hospital (medical, cardiology and coronary care) and five units of a long-term care facility. A total of 142 patients and 51 residents aged 65 and over, with or without dementia, participated in the study and 139 nurses were recruited and trained to use the RADAR tool. Data on each patient/resident was collected over a 12-hour period. The nursing staff and researchers administered RADAR during the scheduled distribution of medication. Researchers used the Confusion Assessment Method to determine the presence of delirium symptoms. Delirium itself was defined as meeting the criteria for DMS-IV-TR delirium. Inter-rater reliability, convergent, and concurrent validity of RADAR were assessed. At study end, 103 (74%) members of the nursing staff completed the RADAR feasibility and acceptability questionnaire.

Results: Percentages of agreement between RADAR items that bedside nurses administered and those research assistants administered varied from 82% to 98%. When compared with DSM-IV-TR criterion-defined delirium, RADAR had a sensitivity of 73% and a specificity of 67%. Participating nursing staff took about seven seconds on average, to complete the tool and it was very well received (≥98%) overall.

Conclusions: The RADAR tool proved to be efficient, reliable, sensitive and very well accepted by nursing staff. Consequently, it becomes an appropriate new option for delirium screening among older adults, with or without cognitive impairment, in both hospitals and nursing homes. Further projects are currently underway to validate the RADAR among middle-aged adults, as well as in newer clinical settings; home care, emergency department, medical intensive care unit, and palliative care.

Citing Articles

Real-World Adherence to a Delirium Screening Test Administered by Nurses and Medical Staff during Routine Patient Care.

Soboh R, Rotfeld M, Gino-Moor S, Jiries N, Ginsberg S, Oliven R Brain Sci. 2024; 14(9).

PMID: 39335358 PMC: 11431038. DOI: 10.3390/brainsci14090862.

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study.

Fabrizi D, Rebora P, Spedale V, Locatelli G, Bellelli G, Di Mauro S Healthcare (Basel). 2024; 12(13).

PMID: 38998829 PMC: 11241281. DOI: 10.3390/healthcare12131294.

Validation to Spanish of nursing assessment scale for early diagnosis of delirium - Nu-DESC.

Henao Castano A, Lozano Gonzalez L, Gomez Tovar L Invest Educ Enferm. 2024; 41(2).

PMID: 38589321 PMC: 10599700. DOI: 10.17533/udea.iee.v41n2e03.

Validation of a viable delirium detection test performed by nurses and physicians during routine patient care.

Soboh R, Gino-Moor S, Jiris N, Ginsberg S, Oliven R BMC Geriatr. 2024; 24(1):297.

PMID: 38549098 PMC: 10976736. DOI: 10.1186/s12877-024-04884-8.

Risk factors, preventive interventions, overlapping symptoms, and clinical measures of delirium in elderly patients.

Mei X, Liu Y, Han Y, Zheng C World J Psychiatry. 2024; 13(12):973-984.

PMID: 38186721 PMC: 10768493. DOI: 10.5498/wjp.v13.i12.973.

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