Detecting and managing cognitive impairment in cardiac patients: insights from qualitative interviews with nurses

Abstract

Background: Cognitive impairment and cardiovascular disease often coexist, and nurses are ideally positioned to detect and manage cognitive impairment in cardiac patients. Objectives: This study explored nurses' perspectives on understanding, detecting, and acting on cognitive impairment in cardiac patients. Design and Methods: Using an exploratory descriptive design, nurses from acute and outpatient cardiac units were interviewed. Data were thematically analyzed. Results: Sixteen nurses were interviewed, working in acute cardiology (n=7), cardiothoracic and intensive care (n=4), and cardiac rehabilitation (n=5). Three themes emerged: (1) Cognitive screening was not routine, with no clear protocols on who, when, and how to screen; (2) Nurses had varying understanding of cognitive impairment, dementia, and delirium; (3) Nurses acted on suspected cognitive changes to ensure patient safety, including referrals and care modifications. Conclusions: Cognitive screening was inconsistent, with barriers, such as workload and lack of education. Guidelines for feasible screening across settings are needed.