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The four items are alertness, cognition (a short test of orientation), attention (recitation of the months in backwards order), and the presence of acute change or fluctuating course.

BEST TOOL: The Confusion Assessment Method (CAM) is a standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately in both clinical and research settings.

The Brief Confusion Assessment Method (bCAM) is a delirium assessment that takes less than 2 minutes to perform. The bCAM is a modified CAM-ICU designed to improve sensitivity in non-critically ill patients and uses objective testing to determine the presence of inattention and disorganized thinking.

The Mini-Mental Status Exam (MMSE) is commonly used to assess a patient's cognitive status when there is a concern of cognitive impairment. The MMSE is sensitive and specific in detecting delirium and dementia in patients at a general hospital and in residents of long-term care facilities.

There are 4 core features including acute onset or fluctuating course, inattention, disorganized thinking, and altered level of consciousness rated with 8 items. 3 of the 4 features must be present for CAM-ICU to be considered positive, ing to the original CAM algorithm.

Content : The Family Confusion Assessment Method (FAM-CAM) is an informant-based variation of the CAM in which a family member or caregiver assesses the patient's mental and cognitive status using a series of questions.

There are 4 core features including acute onset or fluctuating course, inattention, disorganized thinking, and altered level of consciousness rated with 8 items. 3 of the 4 features must be present for CAM-ICU to be considered positive, ing to the original CAM algorithm.

The CAM identifies delirium by the presence of 4 cardinal features scored through a brief cognitive assessment: (1) acute change and fluctuating course, (2) inattention, (3) disorganized thinking, and/or (4) altered level of consciousness.