DOI

10.21007/con.dnp.2026.0150

Faculty Advisor

Tracy McClinton, DNP, APRN, AGACNP-BC, HGET-C, EBP-C

Document Type

Poster

Publication Date

Spring 5-6-2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement

Abstract

Purpose/Background

Delirium is a prevalent complication among critically ill patients in intensive care units (ICUs), associated with increased mortality, prolonged hospital stays, and higher healthcare costs. The Confusion Assessment Method for the ICU (CAM-ICU) is a validated tool designed to aid in the early identification of delirium; however, systematic screening remains low among healthcare professionals. This scoping review aims to evaluate the efficacy of the CAM-ICU in identifying delirium and its potential impact on reducing ICU length of stay.

Method

            This scoping review began by establishing inclusion criteria to ensure the results were applicable to the researchers’ patient population, including patients who could communicate, were over 18 years old, had an intact sense of hearing, were admitted to the intensive care unit, were of any race, ethnicity, or gender, and were capable of giving written informed consent. The researchers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and used multiple reputable databases to identify peer-reviewed articles published within the past 10 years for inclusion in the review. Of 40 articles, 10 were selected for the review using the rapid appraisal tool to assess reliability and relevance. Synthesis tables for levels of evidence and outcomes were also prepared to clearly display the strength and implications of each article. This compiled information was used to determine the relationship between the use of the CAM-ICU screening tool and length of stay.

 

Results

Our analysis revealed mixed outcomes regarding the impact of CAM-ICU on ICU length of stay. Among the ten studies, two reported an increase in length of stay, two noted a decrease, and three showed no significant change. The incidence of delirium showed variability, with four articles reporting decreased rates and two indicating increases. Notably, the reliability of the CAM-ICU was confirmed in only one study, while the use of structured care practices alongside CAM-ICU was highlighted as a potential factor for improved outcomes.

Implications for Nursing Practice

The findings of this scoping review underscore the significance of the CAM-ICU as an effective tool for identifying delirium in critically ill patients. Its use is associated with the potential for improved patient outcomes through early detection and management of delirium. However, the evidence regarding its impact on reducing ICU length of stay is inconsistent, with results varying across studies. Therefore, nurses are encouraged to adopt CAM-ICU in clinical practice as part of a comprehensive delirium management strategy. Combining CAM-ICU with structured prevention and intervention protocols can enhance patient care and may lead to more favorable outcomes. Future research should focus on optimizing these management strategies to better leverage the benefits of the CAM-ICU in practice.

 

 

 

 

 

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