Do Nurses Knowwhen Patients Have Cognitive Deficits?

Abstract

Your ability to assess the cognitive capacity of your elderly patients is crucial to the success of their care.

Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition

“…In previous prospective studies, in which investigators actively assessed for the presence of delirium, delirium has been estimated to occur in 14% to 56% of hospitalized elderly patients. 1 Our results are likely both a reflection of the consistent underrecognition and underreporting (and thus underrecording) of delirium by physicians and nurses found in previous studies 14,[30][31][32] and a possible warning that the problem of poor recognition may be widespread as indicated by the low rates of recorded delirium and related diagnoses found in the VA national health care system. The finding of 53% of study patients with delirium/other related confusional diagnoses being assigned a diagnosis of chronic organic brain syndrome is puzzling.…”

Delirium and transition to a nursing home of hospitalized older adults: A controlled trial of assessing the interdisciplinary team‐based “geriatric” care and care coordination by non‐geriatrics specialist physicians

“…Second, as had been seen in other intervention studies for hospitalized older adults, it is possible that delirium was underdiagnosed by the usual care group physicians. Previous literature explicated the under‐recognition of delirium in the usual care groups as follows: (i) difficulty in identifying the hypoactive form of delirium because of such patients' tendency to cooperate with their care; and (ii) healthcare professionals' tendency to overlook cognitive assessment in a substantial proportion of older hospitalized patients 39 . These two explanations of the ineffectiveness of the ITD intervention to prevent the occurrence of delirium appear to be contradictory.…”

Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale

“…Because of significant and profound negative outcomes of delirium, and its potential reversibility, prompt and effective treatment is dependent upon the early recognition of delirium [12-14]. However, nurses and physicians have been shown to consistently underdiagnosis delirium [12,14-16]. The underrecognition and misdiagnosis of delirium is partly a function of the failure of providers to consistently use standardized methods of detection [15].…”