Adult Nursing Two
The journal article review completed this week is entitled “Nursing tools and strategies to assess cognition and confusion”, written by Thomas Aird and Michelle McIntosh published in the British Journal of Nursing in 2004. Summary of Article
This article focuses the differences between cognition and confusion and highlights chronic states of cognition, such as dementia versus acute states of confusion, or delirium. Dementia, as defined in the article is “long term, irreversible loss of both short term and long term memory”, whereas delirium is described as “an acute confusional state, usually as a result of a physical state”. The authors further states that when assessing a patients cognition, safety of the patient is very important due to the risks associated with being in a confused state either acute or chronic. (Aird & McIntosh, 2004, p.622) A quote included in the article by the famous Florence Nightingale says “…if you do not get into the habit of observation one way or another (including taking notes) you had better give up being a nurse, for it is not your calling”. Patients in a confused state are at an increased risk for falling victim to harm because their orientation and reasoning are skewed. According to the authors, delirious patients are more at risk for unintentional self harm and are 2-5 times more likely to die than unimpaired patients. (Aird & McIntosh, 2004, p. 622) Assessment tools discussed in the article such as the MMSE or Mini-Mental Status Examination, are useful in determining a “baseline” state, but may not be useful for long term analysis of a patient’s ability to reason if they are unable to pay attention for long periods of time. The MMSE tests 6 areas of cognition. These are: orientation such as place and time; registration...