Pregledni rad
https://doi.org/10.24141/1/12/2/6
Assessment of Delirium in the Intensive Care Unit Using the CAM-ICU Tool: The Role of Nurses in Recognition and Care Provision
Valentina Ješić
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy
Dafina Binaj
; University of Novo mesto, Faculty of Health Sciences, Slovenia
Sabina Babić
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy
Nikolina Vratan
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy
Sažetak
Introduction: Delirium is a common neuropsychiatric
syndrome in intensive care units, with a prevalence
ranging from 20% to 80%. It is associated with prolonged
hospital stay, increased mortality, and long-term
cognitive impairment. Due to its fluctuating clinical presentation,
early recognition remains challenging, which
makes the use of validated assessment tools essential.
The Confusion Assessment Method for the Intensive
Care Unit, CAM-ICU, is one of the most widely used instruments.
Nurses, due to their continuous presence at
the bedside, play a key role in screening and initiating
timely interventions.
Methods: A systematic literature review was conducted
using PubMed, Web of Science, and Scopus in September
2025, covering studies published between 2015 and
2025. In accordance with PRISMA guidelines, randomized
controlled trials, clinical and observational studies, educational
interventions, quality improvement projects, and review articles were included. Due to heterogeneity
in study designs, results were synthesized narratively.
Results: Ten studies met the inclusion criteria. The CAMICU
tool demonstrated high diagnostic accuracy, with
sensitivity ranging from 74% to 90% and specificity from
92% to 98%, along with good feasibility in routine nursing
practice. Educational interventions improved nurses’
knowledge, confidence, and documentation rates, while
quality improvement projects reported increased screening
frequency and reduced benzodiazepine use. The most
commonly reported barriers included lack of formal education,
challenges in differential diagnosis, limited assessment
in sedated and mechanically ventilated patients,
and lower assessment frequency during night shifts.
Conclusion: CAM-ICU is a reliable and practical instrument
for the early detection of delirium in intensive care
units. Regular use supported by structured education
and institutional protocols improves assessment consistency
and contributes to safer clinical practice. Further
development of national guidelines and systematic
implementation within the Croatian healthcare system
may improve patient safety and clinical outcomes.
Ključne riječi
delirium; intensive care unit; CAM-ICU; nurses
Hrčak ID:
346606
URI
Datum izdavanja:
28.4.2026.
Posjeta: 285 *