Table 1 NEECHAM Confusion Scale

Subscale I Level of responsiveness-information processing

   • attention and alertness (0 – 4 points)

   • verbal and motor response (0 – 5 points)

   • memory and orientation (0 – 5 points)

Subscale II Level of behaviour

   • general behaviour and posture (0 – 2 points)

   • sensory motor performance (0 – 4 points)

   • verbal responses (0 – 4 points)

Subscale III Vital functions

   • vital signs (0 – 2 points)

   • oxygen saturation level (0 – 2 points)

   • urinary continence (0 – 2 points)

Scores: 0 – 19 points = moderate to severe confusion

20 – 24 points = mild or early development of delirium

25 – 30 points = not confused or normal function