BACKGROUND: Delirium is common among older people in hospital and various 
instruments have been developed for detecting delirium. One of these, the 
NEECHAM Confusion Scale, is easy for nurses to administrate but needs to be 
tested further.
AIMS AND OBJECTIVES: The aim of the present study was to assess the validity and 
predictive value of the NEECHAM Confusion Scale.
METHODS: The study was conducted among 149 patients aged ≥ 65, who had undergone 
surgery for a hip fracture. The patients were observed daily using DSM-IV 
criteria for delirium. The NEECHAM Confusion Scale was performed upon admission 
and prior to discharge.
RESULTS: The incidence of DSM-IV related delirium was 24%. Patients who scored 
below 25 points on the NEECHAM scale had a 12 times higher risk of developing 
DSM-IV related delirium. During admission, the sensitivity of NEECHAM was zero 
because all patients with DSM-IV delirium were excluded, the specificity was 
75%. On discharge, it was 100% and 91% respectively.
CONCLUSIONS: This study adds to the body of knowledge that NEECHAM discriminates 
for delirium. It is a valid and reliable screening instrument for predicting 
delirium. The instrument can be used for clinical practice to identify patients 
who are at risk of contracting delirium and when considering prevention 
measures.