Lastly, the project team learned in the midst of the QI project that unit staff nurses were unclear as to which patients qualified as being cognitively impaired, particularly when a patient did not have a definitive diagnosis. the patients in the rehabilitation unit were easier to identify because the history and diagnosis were well documented prior to admission and cognitive Status was well defined to strategizc therapy needs. The admission process was more controlled; all admissions went through a review process prior to admission, whereas the postsurgical trauma unit admissions arrived from all areas within the hospital and outside the tractate region. Thus, project team members worked closely with the post surgical trauma staff to identify patients appropriate for the project. The project team checked in daily with the bedside nurse to ensure that the project questionnaires and pain assessment evaluation were completed, as well as entering RN-to-KN messages in electronic medical record (IR) system to alert the bedside RN that the patient was included or was a potential candidate to participate in the project. Because patients were often identified 24 hours post admission, data collection for this unit was extended lo postoperative Day 2 with the purpose to capture the peak period of expected pain. When a patient was identified, one-on-one instruction was provided to the bedside nurses.