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Cognitive Screening of Older Hospital Patients: a Quality Assurance Study
Author(s) -
Katz Benny,
Helme Robert D.
Publication year - 1999
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/j.1741-6612.1999.tb00126.x
Subject(s) - medicine , cognition , audit , documentation , psychological intervention , test (biology) , geriatrics , cognitive test , medical record , family medicine , psychiatry , gerontology , paleontology , management , radiology , computer science , economics , biology , programming language
Objective : To evaluate the impact of two educational techniques on the rate of cognitive screening of patients referred to a hospital aged care service. Method : Audit of documentation of cognitive status in the medical record of patients aged 65 years or older referred for aged care consultation in an acute teaching hospital following two interventions: a general education program, and a general education program complemented with a pocket‐sized laminated Abbreviated Mental Test card. Results : Cognitive impairment, defined as Abbreviated Mental Test (AMT) score of 7 or less was present in 49.9% of patients referred for geriatric consultation over a four year period. Documentation of cognitive state by the referring unit, within forty‐eight hours of admission, using a recognised mental status screening instrument was initially 9.4% . Following an education program, documentation of cognitive screening increased to 18.1%, with a further improvement to 28.2% occurring when the education program was supported with a memory aid, a laminated pocket‐sized AMT card. In the following year when the card was provided without an education program, the rate of cognitive screening fell to 13.4%. (p<.0001). The average frequency of a written description of cognition was 50.2% over the four years, and did not increase with the educational programs.Conclusions : Cognitive screening is infrequently performed on older hospital inpatients referred for geriatric consultation, despite a high prevalence of cognitive impairment in this patient group. The rate of cognitive screening can be influenced by the use of an educational program, and further improved with a memory aid. A memory aid without an educational program is less effective.