Clinical Application of a Neonatal Delirium Screening Tool: A Feasibility Study

AIMS: The aims were as follows: (1) to adapt the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) screening tool for use in neonates (SOS-ND), (2) to estimate the accuracy of SOS-ND (used by nurses) compared to assessment by a child psychiatrist using an adapted version of Vanderbilt Assessment of Delirium in Infants and Children and (3) to compare the outcome of assessments of the child psychiatrist and neonatologists. METHODS: A descriptive and comparative design was used. An interdisciplinary group adapted the SOS-PD to develop the SOS-ND. We compared three assessments done on the same day in hospitalized neonates with postmenstrual age at 35-44 weeks in a Danish level IV neonatal intensive care unit. RESULTS: Twenty-six neonates were assessed and five were diagnosed with delirium by the child psychiatrist. An accuracy of 88% [CI 69.9-97.6] was found between SOS-ND screenings during the preceding 24 h and the child psychiatrist's assessment. Neonatologists did not positively identify delirium in the 26 neonates. CONCLUSION: The findings suggest that nurses and the child psychiatrist observe the same condition. By contrast, the absence of delirium diagnosed by experienced neonatologists suggests differences in the conceptualization of the underlying neuropsychological condition.