First Advisor
McNeill, Jeanette
Degree Name
Doctor of Nursing Practice
Document Type
Scholarly Project
Date Created
8-2019
Department
College of Natural and Health Sciences, Nursing, Nursing Student Work
Abstract
Alzheimer’s dementia affects approximately 50 million people in the world and was the sixth leading cause of death in the United States in 2014 (Heron, 2016). The death rate due to Alzheimer’s increased by 55% from 1999 to 2014 (Centers for Disease Control and Prevention, 2017). Several studies have shown that in primary care, the majority of older adults with dementia are undiagnosed (Boustani et al., 2011; Connolly, Gaehl, Martin, Morris, & Purandare, 2011; Sternberg, Wolfson, & Baumgarten, 2000). Mild dementia is particularly under-diagnosed (Van den Dungen et al., 2011). In 2014, the U.S. Preventive Services Task Force concluded current evidence was not sufficient to assess the benefits of screening for cognitive impairment. Routine dementia screening in primary care using cognitive screening tools appeared to improve dementia case detection rates (Eichler et al., 2015). Primary care providers were often not sure which cognitive screening tool to use and some had expressed reluctance to do the screening and use the screening tools due to lack of knowledge. The first purpose of this Doctor of Nursing Practice (DNP) scholarly project was to educate nurse practitioners (NPs) on frequently used dementia screening tools (the Mini-Cog [2018] and Saint Louis University Mental Status Exam tool [SLUMS, Saint Louis University, 2006]) in the clinic. The clinic has five NPs and all NPs consented and iv participated in the project. The education for NPs was done by having one-hour meeting using a PowerPoint presentation. The second purpose was to determine one dementia screening tool that was easy to administer in practice with an administration time of less than 10 minutes by comparing the Mini-Cog (2018) and SLUMS (Saint Louis University, 2006). Nurse practitioners filled out a survey that consisted of five questions with one section where NPs could write comments on which dementia screening tool they thought outperformed the other. The DNP scholarly project itself was a quality improvement project. The method of analysis of the evaluation data was descriptive in nature. The goal of the DNP student was to assess which dementia screening tool was easy to administer, free of educational language or cultural bias, and practical to use with a time administration of less than 10 minutes for a busy primary care setting in a western family medicine clinic. The finding of the DNP scholarly project indicated the Mini-Cog (2018) was not sensitive enough to detect mild cognitive impairment while the SLUMS exam tool (Saint Louis University, 2006) was able to detect mild cognitive impairment in two patients in this clinic. The DNP scholarly project further concluded primary care settings indeed need a dementia screening tool that is easy-to-use and practical but sensitive to detect mild cognitive impairment in elderly patients.
Keywords
Dementia; Alzheimer's dementia; Cognitive screening tool
Extent
114 pages
Local Identifiers
RuslieSP2019
Rights Statement
Copyright is held by the author.
Digital Origin
Born digital
Recommended Citation
Ruslie, Erni Dewi, "Dementia Screening in a Primary Care Clinic: Quality Improvement Project to Identify A Proper Dementia Screening Tool" (2019). Doctoral Capstones & Scholarly Projects. 57.
https://digscholarship.unco.edu/capstones/57