The impact of delirium screening on admission to general hospital using stanford proxy test for delirium sptd1® , a quality improvement project
The impact of delirium screening on admission to general hospital using stanford proxy test for delirium sptd1® , a quality improvement project

Summary/Abstract: In this Quality Improvement Project QIP, we hypothesized that implementing screening tool for detecting delirium at admission to general hospital will term a higher yield; thus early recognition and diagnosis will eventually lead to an early intervention and prevention. Method:We set to screen every patient admitted to a community general hospital. Exclusion criteria: Any congenital neurological malformation, a history of pervasive developmental disorder, or documented brain injury. For this purpose we used The Stanford Proxy Test for Delirium (S-PTD) which is the first diagnostic test for delirium that combines criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases, 10th revision (ICD-10) 2015. This test was generated in Stanford University 2015 by Jose R. Maldonado, MD et al. and discussed in the APM conference in November 2015, in New Orleans then in the APA meeting, 2016 Atlanta, USA. The test assesses the patient’s twelve different parameters. When set the positive cutoff score at 4 or more, the S-PTD had a sensitivity of 79%, specificity of 91%, positive predictive value of 70%, and negative predictive value of 94%. One of the big advantages of this tool is required 2minutes to complete. Also, the nursing staff can easily administer it to their patient during their shift, which means measuring patients cognitive function in different times through the day.1 Results: 19.55% of all admission suffered from delirium on admission, while the admitting officer clinically recognized 5.3% of all admission. Conclusion: using the SPTD1 on admission yield 400% more positive result. It’s highly recommended to use screening tool as part of admission process.

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