What is the primary goal of identifying an ACOC?
The primary goal of identifying ACOCs is to enable staff to evaluate and manage a patient at the facility and avoid transfer to a hospital or emergency room (ER). To achieve this goal, the facility’s staff and practitioners must recognize an ACOC and identify its nature, severity, and cause(s). • Should change in mental status and fever result in rapid hospital transfer? Many of these hospitalizations may not be warranted. For example, if a patient has a fever or a change in level of consciousness, nurses generally have 30 minutes or more to carry out a careful evaluation before deciding whether an emergency transfer is necessary. Transfers should be limited to situations of genuine clinical necessity. Hospitalization of long-term care patients should be avoided for many reasons. Transfer to the ER or hospital is costly; is disruptive for patients; and can expose patients to many risks, including delirium, undernutrition, serious infections, skin breakdown, and adverse drug reactions.
