A Pilot Program to Improve Recognition of Cogntive Impairment in Acute Care

Abstract

Cognitive impairment is a critically important clinical occurrence, but because symptoms may be subtle, it can be overlooked. Conversation about identifying cognitive impairment in the acute care setting often becomes sidetracked by efforts to choose the best screening tool or protocol, with little attention paid to the very first step – recognition that impairment is present. We review how this important problem may not always be detected, documented, and dealt with, and suggest a simple approach to ensuring that affected patients are not missed. This project entails utilizing an old concept in an innovative way. Working with the well-known principle of Universal Precautions, i.e., assuming that any and all body fluids may be contaminated, we refashion the idea into “Universal Observations”, a way of recognizing that any and all acutely ill persons may have cognitive impairment. Additionally, we demonstrate application of the phrase “If you see something, say something” to the hospital environment.