Related Experiment Video
Updated: Jun 10, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
[Delirium on intensive care frequently missed: clinical impression alone is not enough]
Jonna F van Eck van der Sluijs1, Annemarie W Oldenbeuving, Gerwin Roks
1St. Elisabeth Ziekenhuis, Afd. Psychiatrie, Tilburg, the Netherlands.
Objective:
To compare the sensitivity and specificity of a routine assessment (clinical impression) with a structured assessment which uses a validated assessment scale for the recognition of delirium on the intensive care unit (ICU).
Design:
Observational study.
Method:
During their admission to the intensive care unit, 103 patients were assessed daily (with a maximum of 40 days) for the presence of delirium using the Confusion assessment method for the intensive care unit (CAM-ICU). Their physicians indicated whether or not they considered the patient delirious. These findings were compared. For all patients daily information was also collected about fixation and complications, such as self-extubation or self-removal of catheters.
Results:
The patients were assessed for a period of 502 patient-days. CAM-ICU scores were positive (n = 108), negative (n = 235) or non-assessable because the patient was comatosed or deeply sedated (n = 159). The sensitivity of clinical detection by the physicians was 45% in comparison to the CAM-ICU. The specificity was high (97%).
Conclusion:
The diagnosis delirium is frequently missed on the ICU when only based on clinical impression. Routine assessment using a validated assessment scale such as the CAM-ICU might possibly improve this.
Related Concept Videos
Nursing Diagnosis
The nursing diagnosis focuses on evidence-based...
Dementia l: Introduction
Documentation of Nursing Diagnosis
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
Methods of Documentation IV: Focus Charting
It typically involves three columns for recording information:
Nursing Assessment
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments and...
Pneumonia III: Complications and Assessment
