Running Head: Cognition and Confusion

















Cognition and Confusion


Nursing Tools and Strategies to Assess Cognition and Confusion is an article authored by Thomas Aird and Michelle McIntosh. The article is contained in the British Journal of Nursing and was published on May 27-Jun 9, 2004. The article brings out the fact that in the nursing practice, the most overlooked factor is cognitive deficits especially in patients that have suffered from neurological dysfunction. Many words are utilized by nurses in the description of the patients’ mental status without paying any attention to the cognitive deficiencies (Aird & McIntosh, 2004). The reasons for the use of these words is because the nurse and clinicians do not pay attention to the assessment of cognitive status of their patients yet some of the factors linked to the cognitive status might adversely affect the patients’ living activities. The maintenance of patients’ dignity and safety is the fundamental role of nurses and this can only be arrived at through the identifications of any alterations that have occurred on the patient’s mental status. The article propounds the assessment of patient’s mental status that can be conducted on the bedside by nurses and its effects on the nursing practice.

Summary of the Article

The article focuses on a discussion of the cognitive assessment that is suitable for bedside nursing, while at the same time identifying the strategies and tools to be used in the assessing of the patients. This is evidenced by the last line of the introduction states, “the main purpose of this article is to discuss cognitive assessment appropriate to bedside nursing, identifying tools and strategies used to assess patients.” (Aird & McIntosh, 2004). The health assessment procedure and rationale discussed is the bedside cognitive assessment of the mental status of patients using mini-mental status examination. This is based on the simple assessment method propounded by Holden in which a newspaper is provide to a patient for the purpose of gathering different types of information. The assessor involved in this case should be aware of the content of the newspaper for effective assessment. Glasgow Coma Scale is a tool that can be utilized in cognitive assessment but due to its inconsistencies, it can produce positive results even for patients with brain damage. Therefore, the best tool to be utilized as suggested by the article is the Mini-Mental Status Examination, which is utilized for the evaluating psychiatric patients’ cognitive abilities. The population discussed in the article includes the patients whose mental status is in contention as well as the nurses taking care of them.

Evaluation of the Article

            What was well done in this article is the definition of the hard terms in the article. To avoid any form of ambiguity in terms of some words utilized in the article, the authors embark on the definition of such words as confusion, dementia, delirium and disorientation because they are utilized by the clinicians in the description of   the mental status of most patients. The definition of these words goes further in convincing the reader on the need for the cognitive assessment on the part of the nursing practice. Another good aspect of the article is the linking of the article to psychology. This is because Psychology is based on the study of the changes effected in human behavior and mental processes (Aird & McIntosh, 2004). The article bases its argument on the assessment of patients’ mental status. This clearly indicates that the article is appropriate for the psychology course because it provides considerable contributions to the study of the changing human mental behavior and processes. What should have been improved in the article is comprehensive explanation of the Mini-Mental Status Examination for the understanding of all readers.

The reason why this article interested me is the fact that it is meant for the readership of different people (Aird & McIntosh, 2004). This article is intended for the readership of nurses be they registered or psychiatric, physicians, patients the patients’ families and the community at large because cognitive deficits have been ignored by most nurses and physicians such that the actions of patients undergoing alterations in their mental status are not well understood leading to the undermining of patients’ dignity and safety. The mental status of most patients have been affected adversely by the lack of awareness of their environment and self, which culminate into the separation of consciousness and cognition that enhance proper functioning of the mind when the two are combined. For this reason, the article can be appropriate for the readership of the patients. The community and the patients’ families may not be aware of what is ailing the patients. Reading the article can remedy this problem substantially.

The assessment strategy propounded by the article is such that the patients do not need to be moved from their beds because the assessment does not require a lot of movement. The assessment requires the movement of the nurse but not the patient. Consequently, the Mini-Mental Status Examination evaluates psychiatric patients’ cognitive abilities making it beneficial for cognitive assessment (Aird & McIntosh, 2004). Cognitive assessment is beneficial for the nurses because the recognition of patients’ mental status enables the nurses to play the important role of enhancing the patients’ dignity and safety sufficiently. The inclusion of family members during the assessment increases the benefits of the strategy to the patients, family and nurses. The fact that this strategy can be used in addition to other nursing observation makes it beneficial to the patients because the level of their observation is increased making it essay for them to be treated. All practices should adopt this strategy due to its beneficial status.

The strategy can be effectively adopted by my practice because of its effectiveness.

The health assessment strategy was not explained in detail for the complete understanding of the readers hence; the authors should make amendments to the explanation made, with the aim of increasing the understanding level of the reader. More articles and research should be made towards this health assessment so that more tools of assessment can be discovered (Aird & McIntosh, 2004). Using only one tool of assessment might not be a good idea as the tool might work on a certain population of patients while being ineffective to another population of patients. Research should be conducted with the aim of showing how Glasgow Coma Scale tool can be adopted for the effective assessment of the mental status void of any inconsistencies. This article applies to the population of nurses in the nursing practice, psychiatric patients, their families and the community at large.


Nursing Tools and Strategies to Assess Cognition and Confusion an article by Thomas Aird and Michelle McIntosh summarizes the need for cognitive assessment of the mental status of patients in the nursing practice. The purpose of the article which is a discussion of the cognitive assessment that is suitable for bedside nursing, while ate the same time identifying the strategies and tools to be used in the assessing the patients, has been clearly supported by the materials provided by the article (Aird & McIntosh, 2004). The article contains well-researched materials but also brings out the need for the conduction of more research on the topic of cognitive assessment. The article brings out the benefits of the cognitive assessment in that the nurses can utilize it with the aim of enhancing the dignity and security of the patients. It improves the prospects of the nursing practice in terms of careful observation of patients. Mini-Mental Status Examination is brought out as the best assessment strategy because of its effectiveness. In conclusion, though this article is not conclusive in matters of health assessment it forms a foundation for more research into cognitive assessment.


Aird, T., & McIntosh, M. (2004). Nursing Tools and Strategies to Assess Cognition and Confusion. British Journal of Nursing, 13(10), 621-626.

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