Cognitive impairments or disorientation

Provide consistency in health care by limiting the number of staff and minimizing turnover

Provide appropriate lighting and clear signage

Provide a working/accurate clock and up-to-date calendar in patient's room

Orient and reorient patients by explaining where they are, who they are, and the clinician's role in their health care

Introduce cognitively stimulating activities

Encourage/facilitate regular visits from family and friends

Provide one-on-one care, if needed

Dehydration/constipation

Encourage patient to drink adequate fluids

Consider subcutaneous or intravenous fluids (to ensure adequate fluid intake and prevent dehydration) if the patient is unable to adequately hydrate by mouth

Consult specialists if patient has comorbidities that would affect fluid balance (e.g., congestive heart failure, chronic kidney disease)

Hypoxia

Assess for hypoxia

Optimize oxygen saturation as appropriate

Immobility or limited mobility

Encourage early mobilization and active range-of-motion exercises

Infection

Assess for and treat infection

Avoid unnecessary catheterization

Implement infection control

Pain

Continually assess for verbal and nonverbal signs of pain

Initiate and reevaluate for appropriate pain management

Avoid as-needed orders and consider using stop/hold orders

Poor nutrition

Provide adequate supplementation between meals, and culturally sensitive meal choices

Encourage presence of family members at meal times

Ensure patient has dentures that fit properly (if needed)

Sensory impairment

Ensure hearing and visual aids are available and in proper working condition

Sleep

Promote good sleep patterns

Avoid nursing or medical procedures during sleeping hours

Schedule medication rounds to avoid sleep disturbances

Reduce noise to a minimum during sleep periods

Ensure proper and predictable sleep-wake cycles and avoid the patient napping