The CAM-ICU assess on the presence or absence of the following features: acute onset or fluctuation course and inattention and either disorganized thinking or altered level of consciousness, and has a sensitivity to detect delirium of 93-100%, and specificity of 98-100%, and similarly, high higt inter - rater reliability. When the CAM is rated by untrained nurses and without any formal cognitive assessment, delirium is often unrecognized. Thus, although CAM is currently the most widely used instriment for detection of delirium , adequate training is necessary to enhance its sensitivity and specificity. Furthermore, this training should involve nursing staff ebgaged in the care of people with delirium, to improve their clinical skills in detecting and monitoring these patients.