Validity of the Delirium Observation Screening Scale in Identifying Delirium in Home Hospice Patients.
Shea M Jorgensen, Ryan M Carnahan, Michelle T Weckmann
PMID 27413013WHAT IT FOUND
In home hospice patients, the nurse-observed DOS matched the DRS-R-98 in 69 of 75 paired assessments.
It produced 5 false positives and 1 false negative, so a positive screen was not always a delirium diagnosis.
Key findings
01In 23 home hospice patients, the DOS agreed with the DRS-R-98 in 69 of 75 paired assessments.
02Against the DRS-R-98, the DOS had sensitivity of 97% and specificity of 89%, with 5 false positives and 1 false negative.
03Three of the false positives were classified as subsyndromal delirium by the DRS-R-98.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 23 patients were analysed, at one hospice agency, so the accuracy estimates are based on a small sample. The analysis used 75 paired observations from those 23 patients, so patients seen more often could carry more weight. The DOS and the reference rating could be up to 24 hours apart. Patients with severe delirium or dementia could be hard to consent, so the most confused patients may be underrepresented. The study compared two assessment methods; it did not test whether using the DOS changed recognition, treatment, or outcomes.
The easy way to misread this
Do not conclude that using the DOS in home hospice has been shown to improve delirium recognition, treatment, or suffering. It was tested only for agreement with a clinician rating in 23 patients, and false positives occurred.