Safe and high-quality care for patients with cognitive impairment
Cognitive impairment is currently under-recognised in Australian hospitals, leading to significant safety and quality issues. However, harm can be minimised if cognitive impairment is recognised and care is tailored to the needs of the patient.
- Impedes communication, attention, memory, thinking and problem solving
- Means a person may not be able to carry out tasks or be unable to recognise people or objects
- Can be temporary or permanent
- Will affect what the person can understand and how they relate to others and interpret the environment.
Dementia and delirium
Dementia and delirium are the two most common conditions associated with cognitive impairment. People with dementia are also at a greater risk of developing delirium.
People may also be cognitively impaired due to either:
- An acquired brain injury
- A stroke, or
- An intellectual disability.
Any form of cognitive impairment needs to recognised, understood and acted on.
Cognitive impairment in hospitals
For some people with cognitive impairment and for their carers and families, a hospital stay can be a negative experience. Staff can also struggle to provide the right care in the absence of appropriate education and training. Cognitive impairment in hospital is often associated with adverse outcomes, including:
- Functional decline
- Increased risk of falls
- Increased morbidity and mortality.
These adverse outcomes can lead to a longer length of stay in hospital and an increased risk of entry into residential care.
Cognitive Impairment Program
Evidence-based methods exist to improve the care of patients with cognitive impairment in acute care.
Considerable work is under way within health systems at all levels to implement these improvements.
The Commission through the Cognitive Impairment Program is coordinating work to support a systematic approach to improving the safety and quality of care for people with a cognitive impairment in hospital. The main areas of work are:
- The development of the cognitive impairment resources aligned to the National Safety and Quality Health Service (NSQHS) Standards
- The Caring for Cognitive Impairment campaign to raise awareness of cognitive impairment as a quality and safety issue and prepare hospitals for NSQHS Standards (second edition)
- Inclusion of cognitive impairment items in the NSQHS Standards (2nd ed.)
- Release of the Delirium Clinical Care Standard in 2016.