Nursing assessment: Nursing Tools and Strategies to Assess Cognition and Confusion - Article Example

Nursing Assessment: Nursing Tools and Strategies to Assess Cognition and Confusion This is a critical review of article on cognition and confusion by the authors Thomas Aird and Michelle McIntosh. They stress the need for the awareness among the nursing professionals about the differentiation between cognitive impairment and confusion. Confusion simply stated as such by them in their notes does not help identify a patient suffering from cognitive impairment. The authors have highlighted the role of assessment tools such as Glasgow Coma Scale (GCS) and Mini-Mental Status Examination (MMSE).

Overall, the article encompasses all the features of assessment of cognition impairment and confusion. Introduction The article under review has been authored by Thomas Aird and Michelle McIntosh published in 2004 by the British Journal of Nursing in volume 13, issue 10, pages 621-625. The article is an authentic literature in that it is resulting from the combined wisdom of an academician from London South Bank University and practical experience of a senior staff nurse from The National Hospital for Neurology and Neurosurgery, London (Aird & Mclintosh, 2004 ).

The article differentiates between cognitive impairment and confusion. It states that nurses in the hospitals tend to label cases as “appears confused “and that “confusion” often results from physical impairment mostly aggravated by cognitive impairment. Stressing the importance of observational skills for the nurses, the authors quote Florence Nightingale’s exhortation that nurses should develop observational skills including taking notes, as early as in 1860. The article is a literature review on the nursing tools and strategies for assessment of cognition (cognitive impairment) and confusion.

As a qualitative research, the article exhaustively examines how cognitive impairment should be assessed Cognition is explained as the psychological process which enables people to understand what they see, think and remember them in an organized way what is called information processing. Nurses are often said to ignore their patient’s cognitive disabilities and therefore need to master cognitive assessment skills by means of the tools and strategies. Nurses simply mention in their notes that patient appears confused.

The word ‘confused’ is not capable of being clearly defined. Older people with cognitive deficits are less seriously taken than younger people with cognitive deficits. Confusion is the altered state of consciousness and it can be due to delirium which is the result of a physical condition. When a patient appears confused, it should be probed whether it is due to a neurological or some other condition. For example, if a female is eating very little, nurses are quick to conclude that she is either anorexic or apathetic.

But the truth may be that she is depressed, may have forgotten how to eat which cognitively impaired patients tend to display, or she may be unable to see the food on the plate in front of her as can happen in those with visual field deficits. As such, nurses need to observe rightly and be able to differentiate between the three Ds – delirium, dementia and depression symptoms of which are alike (Brooker & Nicol, 2003). The authors of the article being reviewed herein have explained the widely used tool for cognitive function assessment, e.g. the Mini-Mental State Examination (MMSE).

It is a handy tool for use at the bedside. The other tools that can help differentiate causes of confusion have also been mentioned by the authors. Simple way to understand the patient’s cognitive ability is to ask patient to read a news paper and discuss the important news after making sure that the patient can understand the language of the news paper. A nurse can understand the patient’s vision, motor ability and cognitive ability. Nurses can come to an appropriate conclusion by observing the way in which the patient holds and reads the paper and ascertaining whether he/she can remember what he/she has read (Brooker & Nicol, 2003).

The authors have also mentioned the most important tool of Glasgow Coma Scale (GCS) used equally widely for neurological assessment. The authors have given the essence of the extant literature on the cognition and confusion assessment. Conclusion The article has covered all the facets of cognitive assessment and it should serve as a refresher course for nurses in this domain. One feature that is conspicuous by absence is the usual medications required for altering the state of delirium and altering the state of cognitive impairment, though the article is concerned with only assessment tools.

It is noteworthy that the authors have stressed upon the nurses’ duty to honour and respect the dignity of the patient. References Aird, T., & Mclintosh, M. (2004 ). Nusring tools and startegies to assess cognition and confusion . British Journal of Nursing , 13 (10) p 621-626. Brooker, C., & Nicol, M. (2003). Nursing Adults: the practice of eating. London : Elsevier.