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Cognitive assessment of elderly inpatients: a clinical audit.

Shermon E, Vernon LO, McGrath AJ - Dement Geriatr Cogn Dis Extra (2015)

Bottom Line: A descriptive analysis of the results was performed.However, this rate improved to 56% by discharge.Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, Edgbaston Campus, Birmingham, UK.

ABSTRACT

Background: Comprehensive geriatric assessment including cognitive assessment results in better outcomes and quality of life through facilitating access to support and further care. The National Audit of Dementia Care revealed too few patients were being assessed for cognition and therefore failing to receive adequate care.

Methods: This was a retrospective clinical audit in a district general hospital with systematic sampling of the clinical records of 50 inpatients on an elderly care ward. A descriptive analysis of the results was performed.

Results: Despite guidance that cognitive assessment should be performed on admission, this was only documented in 22% of the medical notes. However, this rate improved to 56% by discharge. The most commonly used tool was the Abbreviated Mental Test (AMT) 10. Assessment completion was independent of gender or social support, but only patients aged over 75 years were assessed. Of those, 75% had some level of cognitive impairment and 36.8% received a new or suspected diagnosis of dementia.

Discussion: Cognitive assessment rates continue to be low. Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly.

Conclusion: Cognitive assessment rates need to be further improved to promote better outcomes for patients with dementia.

No MeSH data available.


Related in: MedlinePlus

Rates and timing of cognitive assessment. Total number of patients = 50.
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Figure 1: Rates and timing of cognitive assessment. Total number of patients = 50.

Mentions: Despite guidelines suggesting that cognitive assessment should be performed on admission, with good practice dictating that the clerking doctor should complete this as part of the patient's initial assessment, we found that this was only documented in 22% of the medical notes. Where assessment is not completed on admission or in cases where further assessment is clinically indicated, it is appropriate for doctors on the ward to complete further tests. This is reflected in our finding that assessment rates improved to 56% by discharge (fig. 1). Although these figures initially appear disappointing, they are higher than the level reported in the National Audit of Dementia Care, which found mental status was only assessed in 50% of patients by discharge. We considered the findings of the National Audit of Dementia Care to be a minimum standard to achieve, and our results indicate that local performance was better than the expected standard.


Cognitive assessment of elderly inpatients: a clinical audit.

Shermon E, Vernon LO, McGrath AJ - Dement Geriatr Cogn Dis Extra (2015)

Rates and timing of cognitive assessment. Total number of patients = 50.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4335629&req=5

Figure 1: Rates and timing of cognitive assessment. Total number of patients = 50.
Mentions: Despite guidelines suggesting that cognitive assessment should be performed on admission, with good practice dictating that the clerking doctor should complete this as part of the patient's initial assessment, we found that this was only documented in 22% of the medical notes. Where assessment is not completed on admission or in cases where further assessment is clinically indicated, it is appropriate for doctors on the ward to complete further tests. This is reflected in our finding that assessment rates improved to 56% by discharge (fig. 1). Although these figures initially appear disappointing, they are higher than the level reported in the National Audit of Dementia Care, which found mental status was only assessed in 50% of patients by discharge. We considered the findings of the National Audit of Dementia Care to be a minimum standard to achieve, and our results indicate that local performance was better than the expected standard.

Bottom Line: A descriptive analysis of the results was performed.However, this rate improved to 56% by discharge.Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, Edgbaston Campus, Birmingham, UK.

ABSTRACT

Background: Comprehensive geriatric assessment including cognitive assessment results in better outcomes and quality of life through facilitating access to support and further care. The National Audit of Dementia Care revealed too few patients were being assessed for cognition and therefore failing to receive adequate care.

Methods: This was a retrospective clinical audit in a district general hospital with systematic sampling of the clinical records of 50 inpatients on an elderly care ward. A descriptive analysis of the results was performed.

Results: Despite guidance that cognitive assessment should be performed on admission, this was only documented in 22% of the medical notes. However, this rate improved to 56% by discharge. The most commonly used tool was the Abbreviated Mental Test (AMT) 10. Assessment completion was independent of gender or social support, but only patients aged over 75 years were assessed. Of those, 75% had some level of cognitive impairment and 36.8% received a new or suspected diagnosis of dementia.

Discussion: Cognitive assessment rates continue to be low. Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly.

Conclusion: Cognitive assessment rates need to be further improved to promote better outcomes for patients with dementia.

No MeSH data available.


Related in: MedlinePlus