Research in brief: Researchers develop app to help identify delirium

App-based tool could improve detection of common, deadly complication of hospitalization

Up to 15 percent of all hospitalized patients experience delirium, a form of acute confusion that can result in loss of ability to focus, disorientation, abrupt changes in mood and behavior, and is linked with longer hospital stays and worse outcomes. The condition – more common in older patients – is also linked to cognitive decline and dementia. However, just 12 to 35 percent of delirium cases are identified in routine hospital care.

In an effort to evaluate and implement systemic delirium screening, a team of physician- and nurse-scientists, statisticians, and economists at Beth Israel Deaconess Medical Center (BIDMC) and colleagues developed an app-based, two-step delirium identification protocol based on validated delirium assessment tools previously developed by the research team. The team then tested the app for its ease of use, speed and accuracy in two real-world practices – BIDMC, a large, urban academic medical center in Massachusetts, and Mount Nittany Medical Center, a small, community teaching hospital in rural Pennsylvania. The study tested implementation of the protocol by 3 clinical disciplines including physician hospitalists, nurses, and certified nursing assistants (CNAs), compared to a research gold standard.

“While numerous delirium screening tools have been developed and some have been integrated into electronic health systems, few studies have tested their use by clinicians,” said corresponding author Edward R. Marcantonio, MD, section chief for research in the Division of General Medicine at BIDMC and professor of medicine at Harvard Medical School. “Our study demonstrated that all three of these disciplines were able to complete the app-directed delirium detection protocol over 97 percent of the time. The protocol took an average of less than 1½ minutes to complete, with an overall accuracy rate of 89 percent.”

To learn more, please see the full study published by the Annals of Internal Medicine.