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CRS: Confusion Rating Scale

1988

A four-dimension nursing scale of acute confusion, based on behaviour observed over an eight-hour shift. Its brief structure covers a limited set of features.

At a glance

Purpose
Episodic assessment
Population
Adult
Time
under 5 min after an 8-hour observation period; later summaries describe 1-2 min
Dimensions
4
Score or threshold
Greater than 1 in the current diagnostic-accuracy record; thresholds should be tied to the cited study

Format: Four behavioural dimensions are rated from 0 to 2, producing a total of 0 to 8 after shift observation. The public archived instructions specify an eight-hour period. Use the study-specific threshold and the actual form.

CAM usually means the four-feature short form; the long form has ten items. Check which form and supporting assessment the study used. Short and long CAM explained.

Primary validation papers

1 identified diagnostic-accuracy paper

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

Not yet reviewed.

A focused implementation review has not yet been completed for this profile.

Training and instructions

  • CRS form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
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Tool and original sources

A source for the tool or its access information is linked below. Check the version and current terms before use, copying or adaptation.

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Original paper

  • Original paperWilliams MA, Ward SE, Campbell EB. Confusion: testing versus observation. Journal of gerontological nursing. 1988;14(1):25-30. doi: 10.3928/0098-9134-19880101-08. PMID: 3335761.

    This is the original published source for CRS. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
One DTA study identifiedCore instrument family
Classification

Classification

Episodic assessmentMonitoring for new onset delirium

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceOne DTA study identified

Reported sensitivity and specificity

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Sensitivity
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Specificity

Foundational nurse-rated confusion scale; descriptive study comparing testing with observation.

More evidence and citation details
Full name
Confusion Rating Scale
Also known as
CRS
Evidence summary
single-DTA
Diagnostic-accuracy evaluations
1
Reference standard
CAM assessment by trained research nurse or psychiatrist
Citation
Williams MA, Ward SE, Campbell EB Confusion: testing versus observation Journal of gerontological nursing. 1988;14(1):25-30. PMID 3335761
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Primary validation studies

Distinct primary publications from the current diagnostic-accuracy audit. Reviews and repeated evaluations within one paper are not counted again. Overlapping cohorts have not all been reconciled. Read the counting rules and limitations.

Open 1 identified paper
  1. Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA (2005). Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale. Journal of pain and symptom management.

    Reference category: other comparator or secondary accuracy evidence.

Copyright and reuse
Information checked
2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.