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J Pediatr Intensive Care
DOI: 10.1055/s-0043-1771346
Original Article

The Development and Preliminary Exploratory Validation of the PEdiatric Delirium Scale: Assessing the Feasibility and Accessibility of a Novel Delirium Scale

Authors

  • Emily C. Dodenhoff 

    1   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States

  • Neha Gupta

    2   Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, United States

  • Lauren Craig

    3   Division of Pediatric Critical Care, Children's of Alabama, Birmingham, Alabama, United States

  • Marjorie L. Pate

    3   Division of Pediatric Critical Care, Children's of Alabama, Birmingham, Alabama, United States

  • Sarah D. Petrusnek

    3   Division of Pediatric Critical Care, Children's of Alabama, Birmingham, Alabama, United States

  • Nianlan Yang

    1   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States

  • Kimberly Smith

    1   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States

  • Allison Woolley

    3   Division of Pediatric Critical Care, Children's of Alabama, Birmingham, Alabama, United States

  • Yesie Yoon

    4   Department of Child and Adolescent Psychiatry, Montefiore Medical Center, Bronx, New York, United States

  • Tapan Mehta

    1   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States

  • Leslie W. Hayes

    1   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States

Funding This study was fully supported by the University of Alabama at Birmingham Department of Pediatrics, Division of Pediatric Critical Care. We would also like to thank the partial financial support provided by the National Institute of Diabetes and Digestive and Kidney Diseases (Grant P30 DK056336).
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Abstract

Delirium screening and identification in the pediatric intensive care unit (PICU) can be a diagnostic challenge. Primarily, the burden of screening falls on the bedside nurses, who are juggling countless tasks throughout their shift. The nursing staff at the researcher's institution were concerned that the existing screen, Cornell Assessment for Pediatric Delirium (CAPD), detracted from workflow. The PEdiatric Delirium Scale (PEDS) was developed to accurately identify delirium in children of all developmental abilities and improve nursing workflow. This is a single-center, double-blinded, preliminary exploratory validation study that assesses the feasibility and accessibility of PEDS. This study was performed in a busy 24-bed quaternary PICU serving a diverse, noncardiac patient population. Enrolled patients underwent screening for delirium using the CAPD and PEDS. These results were compared to the gold standard psychiatric evaluation to determine the validity of the novel screen. Finally, the surveyed nurses reviewed their experience with CAPD and PEDS. The primary outcome was to explore the validation of PEDS in the PICU. Using the Youden index, an overall sensitivity of 79% for the detection of delirium (95% confidence interval [CI]: 0.61–0.91) and a specificity of 68% (95% CI: 0.64–0.73) were achieved with an optimal cut-point of 4, on a scale of 0 to 10. PEDS demonstrated a higher predictive value compared to CAPD. Elicited nursing feedback favored PEDS over CAPD, with 86% of respondents citing a shorter time to perform the screen. PEDS is a streamlined tool that can be used to detect pediatric delirium regardless of developmental abilities. Nursing surveys revealed improved workflow when comparing PEDS to CAPD.

Keywords

delirium - pediatric intensive care - workflow - developmental delay

Address for reprint: CPPI 102, 1600 7th Ave South, Birmingham, AL 35233




Publication History

Received: 11 May 2023

Accepted: 15 June 2023

Article published online:
28 July 2023

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