Files and links (1)
Journal of Advanced Nursing - 2026 - Mudge - Care Needs for Patients Screened Positive for Cognitive Impairment and464.93 kB
Published Version (Advanced Access)CC BY-NC-ND V4.0, Open Access
Journal article
Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study
Journal of Advanced Nursing, Vol.Advanced access
05-Mar-2026
PMID: 41787740
Abstract
Aim
To describe the point prevalence of cognitive impairment in hospitalised adults and evaluate the association with care needs and perceived risks of complications.
Design
Multi-site cross-sectional study on a single day in May 2023.
Methods
Trained clinician auditors screened adult inpatients in acute medical, surgical, oncology, geriatric, mental health, convalescent, and rehabilitation wards for cognitive impairment using the 4AT in seven healthcare facilities and recorded need for support with basic activities of daily living, incontinence, and perceived risks of complications (falls, pressure injuries, and malnutrition). Data were summarised and compared across 4AT categories, and the strength of association between 4AT and each outcome was estimated using multivariable regression models.
Results
Data were available for 1145 inpatients on 68 wards (mean age 68 years [SD = 18], 583 [58.9%] female, 449 [39.2%] on acute medical units). Cognitive impairment (4AT of 1 or more) was identified in 482 (42.1%) participants. Participants with 4AT 1–3 had 2.0–3.6 times the odds of need for supervision or assistance with activities of daily living, while those with 4AT 4 or more had 2.9–5.3 times the odds of need for assistance.
Conclusion
Cognitive impairment is very common in adult inpatients and is associated with significantly higher physical care needs.
Implications for the Profession and Patient Care
Hospital care models must support staff to address the higher care needs in people with cognitive impairment to protect a large patient group from hospital-acquired harm.
Patient or Public Contribution
No patient or public contribution.
Reporting Method
This study adheres to the STROBE reporting guidelines.
Details
- Title
- Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study
- Authors
- Alison M Mudge (Corresponding Author) - The University of QueenslandSarah Anderson - Metro North Health (Australia)Aparna Arjunan - Metro North Health (Australia)Marguerite Byrnes - Caboolture Hospital (Australia)Margaret Cahill - Royal Brisbane and Women's HospitalAlison Craswell - University of the Sunshine CoastJoel Dulhunty - The University of QueenslandAmanda Fox - Queensland University of TechnologyNicole C Gavin - Metro North Health (Australia)Peter Lawrenson - Metro North Health (Australia)Karen Lee-Steere - Queensland HealthHui-Shan Lin - Metro North Health (Australia)Andrew Teodorczuk - The University of QueenslandElise Treleaven - Royal Brisbane and Women's HospitalLaura White - Prince Charles HospitalChloe Yap - Metro South Health
- Publication details
- Journal of Advanced Nursing, Vol.Advanced access
- Publisher
- Wiley-Blackwell Publishing Ltd.
- DOI
- 10.1111/jan.70530
- ISSN
- 1365-2648; 0309-2402
- PMID
- 41787740
- Copyright note
- This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.
- Data Availability
- The data that support the findings of this study are available on reasonable request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health - Nursing
- Language
- English
- Record Identifier
- 991214281402621
- Output Type
- Journal article
Metrics
1 Record Views