American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2014, 2(2), 17-19
DOI: 10.12691/ajnr-2-2-1
Open AccessArticle

Acute Confusion and Advanced Nursing Practice

Paulo Marques1, , Paulino Sousa2 and Abel Silva2

1Scientific Pedagogical Unit, “Education and Management in Nursing”, Porto Nursing School, Porto, Portugal

2Porto Nursing School, Porto, Portugal

Pub. Date: April 28, 2014

Cite this paper:
Paulo Marques, Paulino Sousa and Abel Silva. Acute Confusion and Advanced Nursing Practice. American Journal of Nursing Research. 2014; 2(2):17-19. doi: 10.12691/ajnr-2-2-1


Acute confusion is a frequent and serious phenomenon in hospitals mainly affecting the older people. Patients with acute confusion are more vulnerable to threats to their security, such as falls, not only because they have an increased risk but also because the nurses have difficulty in the identification and treatment of acute confusion. Challenges emerge related to quality and continuity of nursing care provided to these patients, including the introduction of measuring instruments of acute confusion and the implementation and evaluation of the effectiveness of specific nursing therapies in clinical practice. The research came after another were was identified an algorithm for the management of confusion. Through an action research methodology it was introduced in the documentation system in use, widespread in Portugal, as a decision support system. The aim of this study was to evaluate the effectiveness of a model that supports the conception of nursing care in confusion patients. After six months of assisting nursing practice, was identified the reduction of the under diagnosis of acute confusion, a low incidence of acute confusion new cases and a revaluation of reality orientation and family involvement as important nursing interventions.

nursing confusion decision making continuity of patient care

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Sendelbach S, Guthrie PF. Acute confusion/delirium – identification, assessment, treatment and prevention. J GerontolNurs 2009; 35(11): 11-18.
[2]  Potter J, George J. The prevention, diagnosis and management of delirium in older people: concise guidelines. Clin Med 2006; 6(3): 303-308.
[3]  Waszynski C, Petrovic K. Nurses' evaluation of the Confusion Assessment Method: a pilot study. J GerontolNurs [serial on the Internet]. (2008, Apr), [cited September 29, 2010]; 34(4): 49-56.
[4]  Neelon VJ, Champagne MT, Carlson JR, Funk SG. The NEECHAM Confusion Scale: construction, validation and clinicaltesting. NursRes 1996; 45: 324-330.
[5]  Britton A, Russel R. Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment [CD000395]. Oxford: The Cochrane Library, Issue 1; 2006.
[6]  Faria H, Silva A, Marques P. Physical Restriction of Mobility:A Study of the Various Aspects of its use for Therapeutic Purposes. RevEnfRef 2012; III série(6): 7-16.
[7]  Marques P, Sousa P, Silva A. Acute Confusion: Data to the Decision of Nurse. Rev Enf Ref 2013; III série (9).
[8]  Hugo N, Silva A, Marques, P. Translation and cultural adaption of the NEECHAM Confusion Scale. RevEnfRef 2011; III série(3): 105-112.
[9]  Meagher D. Motor subtypes of delirium: past, present and future. Int Rev Psychiatr 2009; 21(1): 59-73.
[10]  Speed G, Wynaden D, McGowan S, Hare M, Landsborough I. Prevalence rate of delirium at two hospitals in Western Australia. Aust J AdvNurs [serial on the Internet]. (2007, Sep), [cited September 29, 2010]; 25(1): 38-43.
[11]  Benedict L, Hazelett S, Fleming E, Ludwick R, Anthony M, Fosnight S et al. Prevention, detection and intervention with delirium in an acute care hospital: a feasibility study. Int J Old People Nur 2009; 4: 194-202.
[12]  Aguirre E. Delirium and hospitalized older adults: a review of nonpharmacologic treatment. J Cont Edu Nur 2010; 41(4): 151-152.
[13]  Holroyd-Leduc JM, Khandwala F, Sink KM. How can delirium best be prevented and managed in older patients in hospital? Can Med Am J 2010; 182(5): 465-470.