| ARCHETYPE ID | openEHR-EHR-OBSERVATION.kopi_test_4at.v0 |
|---|---|
| Concept | kopi_test_4at |
| Description | The 4AT is a screening instrument designed for rapid initial assessment of delirium and cognitive impairment. |
| Use | Use to detect delirium at first contact with the patient, and at other times when delirium is suspected. Note that the 4AT is not designed for repeated daily monitoring for new onset delirium (because of practice effects with the Months Backwards task). Altered level of arousal (Item 1), and change or fluctuation (Item 4) can readily be used daily or even more frequently, along with general clinical judgement and/or use of tools specifically designed for ongoing monitoring of delirium. |
| Misuse | Not to be used for repeated daily monitoring for new onset delirium (because of practice effects with the Months Backwards task). |
| Purpose | To detect delirium at first contact with the patient, and at other times when delirium is suspected. |
| References | https://www.the4at.com/ |
| Copyright | © Nasjonal IKT HF |
| Authors | Author name: John Tore Valand Organisation: Helse Bergen HF Date originally authored: 2019-02-18 |
| Other Details Language | Author name: John Tore Valand Organisation: Helse Bergen HF Date originally authored: 2019-02-18 |
| Other Details (Language Independent) |
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| Keywords | delirium |
| Lifecycle | in_development |
| UID | 4eb69359-2814-4a0e-a8df-049dc81840b6 |
| Language used | en |
| Citeable Identifier | 1013.1.2316 |
| Revision Number | 0.0.1-alpha |
| state | |
| Confounding factors | Confounding factors: * |
| events | |
| Any point in time event | Any point in time event: Unspecified point in time event which may be explicitly defined in a template or at run-time. |
| protocol | |
| Extension | Extension: Additional information required to capture local content or to align with other reference models/formalisms. For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents. Include: All not explicitly excluded archetypes |
| data | |
| [1] ALERTNESS og greier | [1] ALERTNESS og greier: This includes patients who may be markedly drowsy (eg. difficult to rouse and/or obviously sleepy
during assessment) or agitated/hyperactive. Observe the patient. If asleep, attempt to wake with speech or gentle touch on shoulder. Ask the patient to state their name and address to assist rating. 0: Normal (fully alert, but not agitated, throughout assessment) or Mild sleepiness for <10 seconds after waking, then normal [*] 4: Clearly abnormal [*] |
| [2] AMT4 | [2] AMT4: Age, date of birth, place (name of the hospital or building), current year. 0: No mistakes [*] 1: 1 mistake [*] 2: 2 or more mistakes/untestable [*] |
| [3] ATTENTION | [3] ATTENTION: Months of the year backwards. Ask the patient: “Please tell me the months of the year in backwards order, starting at December.” To assist initial understanding one prompt of “what is the month before December?” is permitted. 0: Achieves 7 months or more correctly [*] 1: Starts but scores <7 months / refuses to start [*] 2: Untestable (cannot start because unwell, drowsy, inattentive) [*] |
| [4] ACUTE CHANGE OR FLUCTUATING COURSE | [4] ACUTE CHANGE OR FLUCTUATING COURSE: Evidence of significant change or fluctuation in: alertness, cognition, other mental function. eg. paranoia, hallucinations) arising over the last 2 weeks and still evident in last 24hrs. 0: No [*] 4: Yes [*] |
| 4AT score | 4AT score: The sum of the 4 ordinal scores for each component parameter. min: >=0; max: <=14 |
| Comment | Comment: Additional narrative about the overall 4st test captured in other fields. |
| Other contributors | Univsersity |
| Translators |