CAM positive (TISS Item)

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

TISS Item
Item Description	CAM positive (TISS Item)
TISS28 Category:	Neurological Support
TISS28 Item	0
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
  • if an Acquired Procedure, enter the Px Date for each day that they happen
  • if an Admit Procedure leave the date blank
• 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

Cargo:

SMW: add to Category:CCI wiki infrastructure

The Confusion Assessment Method 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]

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

Data problems

Problems were flagged in:

• TISS28 collection Survey January 7, 2013
• TISS28 collection & scanning Survey April 16, 2013

Template:Discussion Did these ever get better? Ttenbergen 12:44, 2017 May 11 (CDT)

• 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)

Reporting

• The information was requested by Dr Arora - Quarterly report showing the monthly statistics regarding the Delirium/Confusion cases in complication Diagnosis, counts of patients with at least one day marked with CAM+ and total CAM+ days and their associated rates for STB ICMS, ICCS and ACCU.

• Report included in the Critical Care Regional OpPlan as requested by the QI Officer - Quarterly report of Delirium cases, Delirium Rates, Delirium Days and Delirium Rate Days for all ICUs in the region

• New - WRHA Critical Care Quality Indicator Chart Report for Directors and Managers - Quarterly report of Delirium cases, Delirium Rates, Delirium Days and Delirium Rate Days for all ICUs in the region

See also

• Quick Reference
• Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)
• Confusion/Delirium