CAM positive (TISS Item)

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This procedure is a part of CCI Collection via CCI Picklist.

Item Description CAM positive (TISS Item)
TISS28 Category: Neurological Support
TISS28 Item 9
TISS28 Description CAM "+" any time today
TISS28 Points 0
TISS28 Start Date
TISS28 End Date
TISS28 Comment: added for Dr. Arora & Critical Care QI Team
CCI Picklist
CCI Picklist code:
CCI Collection Mode: CCI collect each day
CCI Picklist Start Date Needs to be either CCI TISS Start, or later if TISS start date is later (which it should never be?)

Collecting "CCI collect each day" items

  • "CCI collect each day" items are entered each time they happen
  • Px Date
  • Px Count
    • enter 1 regardless of how many times a day the procedure happened
  • this is usually the collection mode for TISS28 items, see TISS28 Collection Guide, and for some items that have replaced TISS items

Px Date for patients who move

See Px Date#Moves


SMW: add to Category:CCI wiki infrastructure

About CAM Evaluation

  • CAM stands for Confusion Assessment Method-- it is an instrument for use in the intensive care unit to accurately diagnose delirium in critically ill patients who are often nonverbal because of mechanical ventilation."[1]
    • To even be evaluable for CAM assessment, a patient must be conscious. Thus, in reality, a given CAM assessment has 3 possible findings: (i) not evaluable, (ii) evaluable and CAM-positive, or (iii) evaluable and CAM-negative.
  • CAM status is currently recorded in ICUs in two places:
    • On the ICU flowsheet, as an indication of CAM-positive versus not being CAM-positive; as above the latter includes evaluable and CAM-negative or not evaluable. Of note, the ICU nurses evaluate for delerium multiple times per day.
    • On the TISS sheet, as a bubble for being CAM-positive versus not being CAM-positive. Here there is just a single yes/no bubble, so that NOT being CAM-positive can mean either that there were no evaluable assessments during that day or that there was at least one evaluable assessment and all of those were CAM-negative.
  • The users of this data (including Rakesh Arora in ICCS) are mainly counting the number of ICU days in which a patient is CAM-positive -- which of course only includes days on which there is at least one CAM-evaluable assessment.

We are collecting CAM as T9 - CAM positive (TISS Item).

CAM ICU Training

Data problems

Problems were flagged in:

Old discussion:

  • Hard to tell in the numbers (whether marking is legit or not). Maybe another round of survey will help - are the data collectors marking or crossing out the entry if they find inconsistencies from various sources?--JMojica 14:02, 2017 May 11 (CDT)
    • If I find inconsistencies I will correct and/or clarify with the bedside nurse Lisa Kaita 14:21, 2017 May 11 (CDT)
    • I will do the same as Lisa, but it isn't always easy to clarify the CAM status of a patient if I am checking TISS sheets from previous days. Sometimes the systems review notes don't seem to correlate with the CAM score on the flow sheet. I have to use my judgement in these cases, so the CAM positive days are not always accurate.Mlagadi 14:57, 2017 May 18 (CDT)

Data use

See also

Data Integrity Checks (automatic list)

Query check CCI TISS time means must be twoCCMDB.accdbdeclined
Query check CCI TISS CAM positive vs DxCCMDB.accdbdeclined

Related articles

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