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

<i>Background:</i> Cognitive impairment and cardiovascular disease often coexist, and nurses are ideally positioned to detect and manage cognitive impairment in cardiac patients.<i>Objectives:</i> This study explored nurses' perspectives on understanding, detecting, and acting on cognitive impairment in cardiac patients.<i>Design and Methods:</i> Using an exploratory descriptive design, nurses from acute and outpatient cardiac units were interviewed. Data were thematically analyzed.<i>Results:</i> 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.<i>Conclusions:</i> Cognitive screening was inconsistent, with barriers, such as workload and lack of education. Guidelines for feasible screening across settings are needed.