The 2013 SCCM PAD guidelines recommend such valid and reliable delirium screening tools as the CAM-ICU and the ICDSC. Using these tools, you should screen moderate- to high-risk patients at least once per nursing shift.
Don’t Forget about Dr. DRE
When a patient is diagnosed with delirium, the main concern tends to be over what drug they should be given. The real issues, however, are the environmental disease-related causes that need to be prevented and the drugs that need to be removed, such as GABAergics. A pneumonic tool called Dr. DRE is used to diagnose delirium. Remember the tool by thinking of rapper, record producer, and entrepreneur Dr. Dre -- headphones sold by the company he co-founded, Beats by Dr. Dre, are shown here. This slide defines the Dr. DRE acronym. “D” represents diseases such as sepsis, chronic obstructive pulmonary disease, hypoxemia, and congestive heart failure. “DR” represents drug removal, which is achieved using SATs and by stopping the use of benzodiazepines and narcotics. “E” represents the environment encompassing patient immobilization. The constant activity in acute care units can lead to disturbed sleep/wake cycles and circadian rhythms. Keep in mind some of the things you can do to make the hospital environment less stressful, including providing hearing aids or glasses for the patient, keeping the patient unrestrained, and ensuring tolerable noise levels around the unit.