Loading...
Assessment and Documentation of Neuropsychiatric Symptoms in Hospitalized Patients with Dementia
Authors
Kim, Lana
Kim, Lana
Advisor
Date
2021-05
Embargo until
Language
Book title
Publisher
Peer Reviewed
Type
DNP Project
Research Area
Jurisdiction
Collections
Other Titles
Neuropsychiatric Assessment for Dementia
See at
Abstract
Data Availibility
Data / Code Location
Table of Contents
Description
Citations
Altmetric:
Series/Report No.
Sponsors
Problem and purpose: Nursing assessment and documentation of neuropsychiatric symptoms
(NPS) for patients with dementia (PwD) are critical for symptom management, treatment and
discharge planning. Lack of standardization and inadequate documentation may lead to
inadequate treatment, prolonged hospitalization, or denial of admission to care facilities
following discharge. The purpose of this quality improvement (QI) project was to improve
clinical management of dementia, by implementing an evidence-based protocol for standardized
assessment and documentation of NPS, using the Neuropsychiatric Inventory-Questionnaire
(NPI-Q).
Methods: This QI project was implemented over 12 weeks in late 2020 on a 14-bed inpatient
behavioral health unit (BHU) with an average daily census of 1-2 patients with dementia. A
validated and reliable tool (the NPI-Q) was introduced to the unit for accurate, standardized
assessment of NPS. The number of patients who received the prescribed number of NPI-Q
assessments per hospitalization and the number of patients who showed improvements in NPI-Q
total and domain scores from admission to discharge were evaluated.
Results: The mean age of the patients was 74 years (range 65 to 85); there were equal numbers of
males and females. Seventy-four percent of patients received the targeted number of NPI-Q
during their hospitalization. Additionally, 67% of patients who received both admission and
discharge NPI-Qs had improved NPI-Q scores at discharge. The mean for admission NPI-Q
scores was 7.6 (SD = 3.2) compared to discharge NPI-Q scores of 3.4 (SD = 4.3). There were no
significant relationships between age and admission NPI-Q scores (p = .4); age and discharge
NPI-Q scores (p = 1.0); gender and admission NPI-Q scores (p= 1.0); gender and discharge NPIQ
scores (p = 1.0); age and length of stay (LOS), or gender and LOS (p = 1.0). Conclusions: Using a structured, validated instrument is likely to improve assessment and
documentation of NPS among patients with dementia in an inpatient BHU. Although the number
of assessed patients was small, it appears that this practice change was well accepted by nurses,
is sustainable, and may improve communication among health care teams and quality of care, as
evidenced by improved NPI-Q scores from admission to discharge.