JMIR Publications

ABSTRACT

Background:

The 3-minute Diagnostic Interview for CAM-Defined Delirium (3D-CAM) is an instrument specially developed for the assessment of delirium in the general wards, with identified high sensitivity and specificity. However, the use of 3D-CAM by bedside nurses in routine practice showed relatively poor usability with multiple human errors during assessment.

Objective:

To develop a mobile-based delirium assessment tool based on the 3D-CAM and evaluate its usability among older patients by bedside nurses.

Methods:

The 3D-DST (delirium assessment tool with decision support function based on the 3D-CAM) was developed to address existing issues of the 3D-CAM and optimized the assessment process. Following a randomized cross-over design, questionnaires were used to evaluate the usability of the 3D-DST among older adults by bedside nurses. Meanwhile, the performance of both the 3D-DST and the 3D-CAM paper version, including the assessment completion rate, time required for completing the assessment, and the number of human errors made by nurses during assessment, were recorded and their differences were compared.

Results:

The 3D-DST included 3 assessment modules, 9 evaluation interfaces and 16 results interfaces, with built-in reminders to guide nurses in completing delirium assessment. In the usability testing, a total of 432 delirium assessments on 148 older adults were performed by 72 bedside nurses. Compared to the paper version, the mean usability score was significantly higher when using the 3D-DST (4.35 vs 3.41). The average time in completing the assessment reduced by 2.10 minutes (P<0.001) when the 3D-DST was used.

Conclusions:

This study demonstrated that the 3D-DST significantly improved the efficiency of delirium assessment and was considered highly acceptable by bedside nurses. Clinical Trial: ClinicalTrials.gov, ChiCTR-IOR-17,010,368