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Printed on 4/21/2026
For informational purposes only. This is not medical advice.
The NEECHAM Confusion Scale is a nursing observation instrument scored from 0 to 30 that evaluates processing, behavior, and physiologic control dimensions. Higher scores indicate normal function; lower scores indicate increasing confusion and delirium risk.
Formula: NEECHAM total = summed scale points (0-30), where lower scores indicate greater confusion.
NEECHAM has published validation as a nursing confusion/delirium observation scale in hospitalized patients.
Lower NEECHAM totals indicate stronger confusion/delirium signal and need for closer evaluation.
Use in inpatient settings for serial nurse-led monitoring of cognitive status and early delirium detection.
Observer variability and overlap with dementia/sedation states can influence specificity.
For related assessments, see DOSS, Nu-DESC and CAM Delirium Screen.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
A nursing observation-based delirium screen scored 0-13, with >=3 commonly treated as positive.
GeriatricsA brief 5-item nursing delirium screen (0-10) commonly using >=2 as a positive threshold.
GeriatricsScreen for delirium using the CAM (Confusion Assessment Method). Gold standard with ~94% sensitivity and ~89% specificity. Requires acute onset + inattention, plus disorganized thinking or altered consciousness.
GeriatricsRapid delirium screening tool scored 0-12; scores of 4 or more suggest possible delirium.