Nursing Care for Hospitalized Older Adults With and Without Cognitive Impairment.
Tamara G R Macieira, Yingwei Yao, Madison B Smith and 3 others
PMID 31972847WHAT IT FOUND
Hospitalized older adults with cognitive impairment were less likely to receive physical comfort care in seven of nine units.
Pain was often the only physical comfort problem documented, while those without impairment also had nausea, vomiting, or fatigue.
Key findings
01Hospitalized adults aged 85 and older with cognitive impairment were less likely than those without cognitive impairment to receive physical comfort care in seven of the nine units.
02Pain was often the only physical comfort problem documented for older adults with cognitive impairment, while pain, nausea and vomiting, and fatigue were commonly identified among older adults without cognitive impairment.
03Length of stay was 5.1 days for adults with severe cognitive impairment, 4.3 days for moderate impairment, and 2.7 days for mild or no impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Cognitive impairment was identified only from nursing diagnosis-intervention-outcome entries classified as mental, so patients with medical diagnoses or other cognitive screens may have been missed. Gender and race or ethnicity were not analyzed because many records were missing those fields. The data came from Midwest hospitals, so care patterns may not match other regions. The analysis did not include medical diagnoses, treatments, medications, preadmission status, caregiver support, comorbidities, or unit culture, so other factors may explain the differences. The study was observational and used admission plans of care, so it cannot show that nursing care caused length of stay or that patients were undertreated. Documented nursing care may reflect what nurses recorded, not everything they did.
Declared interests
No author conflict-of-interest declaration appears in the supplied text. The article is marked as supported by NIH extramural research funding.
The easy way to misread this
Do not conclude that nurses caused lower physical comfort care or that cognitive impairment itself made patients less comfortable. This is an observational analysis of admission nursing documentation, and differences may reflect how symptoms were recognized or recorded; medical diagnoses, medications, and comorbidities were not included.