4AT - RAPID CLINICAL TEST FOR DELIRIUM

Time 2020-12-18 15:03:54

Web Name: 4AT - RAPID CLINICAL TEST FOR DELIRIUM

WebSite: http://www.the4at.com

ID:138241

Keywords:

CLINICAL,RAPID,AT,

Description:

WHAT IS THE 4AT?The4ATis a short tool for delirium assessment. It is designed to be easy to use in clinical care.Many practitioners have found that adoption of the 4AT has helped to increase delirium detection in their place of work.Download and use is free. Key features of the 4AT delirium assessment tool ♦ 2 minutes♦ no special training is required♦ designed specifically for routine clinical practice♦ easy and simple♦ suitable for use by all practitioners with a basic knowledge of delirium♦ all patients can be assessed, including those unable to speak (eg. with severe drowsiness), so no patients are ‘Unable to Assess’♦ has built-in brief cognitive testsvalidation The 4AT is one of the best-validated delirium assessment tools globally. A meta-analysis of 17 studies (N=3701 observations) found a pooled sensitivity of 88% and a pooled specificity of 88%.Clinical implementationThe 4AT is proven as a tool that can be implemented into clinical work, with (a) good rates of completion, and (b) delirium detection at the predicted level. See here for an example. The 4AT is recommended for clinical use in multiple international guidelines and pathways.Do I need permission to download and use?No permission or registration is required to download and use. This includes use in Electronic Medical Records (EMRs).Clinical use of the 4ATThe 4AT is designed to be used by any health professional at first contact with the patient,and at any other time when delirium is suspected. It incorporates the Months Backwards testand the Abbreviated Mental Test - 4 (AMT4), which are short tests for cognitive impairment. This provides basic cognitive testing, aimed at detecting moderate-severe cognitive impairment, alongside assessment for delirium. Scores of 1-3 indicate possible cognitive impairment, with delirium less likely. This is useful in triggering more detailed cognitive assessment and informant history to determine if there is longer-term cognitive impairment (which is often undiagnosed). See the guidelines on the 4AT form for more information.Note that the 4AT is not designed for repeated 2-3 times per day monitoring for new onset delirium in inpatients. Monitoring tools like the Single Question in Delirium (SQiD) or the National Early Warning Score - 2 (NEWS2) are suitable for this purpose. If the monitoring tool is positive, then the 4AT is done to assess in more detail the possible presence of delirium. NEWS2 as a monitoring tool with the 4AT as the delirium assessment tool is the recommended process in the UK National Health Service. See here for more details.WHY was THE 4AT DELIRIUM ASSESSMENT TOOL written?REFERENCES (INCLUDING VALIDATION STUDIES)Delirium Words: a blog on delirium by the 4AT main author4AT Wikipedia pageNote: responsibility for the interpretation of scores and any actions rests with the clinical team using the 4AT. As per accepted clinical practice, a diagnosis of delirium should always be made following clinical assessment by suitably qualified staff.Website:Alasdair MacLullich

TAGS:CLINICAL RAPID AT 

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4AT: rapid assessment test for delirium. Designed by Alasdair MacLullich (University of Edinburgh), Tracy Ryan and Helen Cash (NHS Lothian). Used in clinical care by doctors, nurses, and other healthcare professionals to detect delirium.

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