eng Science and Education Publishing American Journal of Nursing Research 2014-04-28 2 2 17 19 10.12691/ajnr-2-2-1 AJNR2014221 article Paulo Marques paulomarques@esenf.pt 1 Paulino Sousa 2 Abel Silva 2 Scientific Pedagogical Unit, “Education and Management in Nursing”, Porto Nursing School, Porto, Portugal Porto Nursing School, Porto, Portugal 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. http://pubs.sciepub.com/ajnr/2/2/1/ajnr-2-2-1.pdf nursing confusion decision making continuity of patient care