Delirium Observation Screening (DOS) Scale

Delirium is one of the most frequent forms of cognitive impairment in elderly patients and inpatients at the end-of life. Delirium develops in a short period of time and symptoms fluctuate during the day. The Delirium Observation Screening Scale is a 13-item observational scale of verbal and nonverbal behavior. The observations can be done during regular care. To optimize recognition of delirium, recording of observations per shift is important.

Score

  • For each shift the total score is calculated by counting each rating; the total score per shift is a minimum of 0 and a maximum of 13
  • Adding the total scores per shift gives the total score for a day; the total score for a day is a minimum 0 and a maximum of 39
  • The DOS Scale final score is calculated by dividing the total score for today by 3; the DOS final score is between 0 and 13
  • A DOS Scale final score < 3 means that the patient is most probably not delirious; a DOS Scale final score of >= 3 means that the patient is most probably delirious

Translated by and reproduced here with the permission of Marieke Schuurmans.

See Schuurmans MJ, Shortridge-Baggett, L.M., Duursma, S.A.,. 2003. The delirium observation screening scale: a screening instrument for delirium. Research in Theory and Nursing Practice 17: 31–50

status:published
version:1.1
source:
tags: mental health, delirium

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Dozes off during conversation or activities
 
never [0]
sometimes-always [1]
Is easily distracted by stimuli from the environment
 
never [0]
sometimes-always [1]
Maintains attention to conversation or action
 
never [1]
sometimes-always [0]
Does not finish question or answer
 
never [0]
sometimes-always [1]
Gives answers that do not fit the question
 
never [0]
sometimes-always [1]
Reacts slowly to instructions
 
never [0]
sometimes-always [1]
Thinks they are somewhere else
 
never [0]
sometimes-always [1]
Knows which part of the day it is
 
never [1]
sometimes-always [0]
Remembers recent events
 
never [1]
sometimes-always [0]
Plucks at bedclothes, agitated and restless
 
never [0]
sometimes-always [1]
Pulls IV tubing, feeding tubes, catheters etc.
 
never [0]
sometimes-always [1]
Is easily or suddenly emotional
 
never [0]
sometimes-always [1]
Sees/hears things which are not there
 
never [0]
sometimes-always [1]

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