The Impact of a Provider Dementia Education Program on Dementia Screening, Documentation of Dementia Diagnosis, and Community Referral In a Rural Primary Care Setting
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Date
2019-05-14
Type of Work
Department
Nursing
Program
Doctor of Nursing Practice
Citation of Original Publication
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Abstract
Problem Statement: Primary care providers’ lack of knowledge regarding dementia screening, diagnosis, and treatment can lead to missed or delayed dementia diagnosis, inadequate care planning, and a lack of referral to community resources. Purpose: To evaluate the effectiveness of a provider dementia education program in improving early identification of dementia and community service referral for individuals age 65 and older in a rural primary care practice. Methods: A two-month pre-intervention chart review of patients presenting for initial or subsequent Annual Wellness Visits (AWV) was conducted. Data on documentation of dementia diagnosis, screening, type of screening tool used, advance care planning discussion, and community service referrals were collected. A one-hour dementia education program was implemented for all providers followed by data collection for two months for evidence of increased screening and identification of those with dementia as well as review of their use of other healthcare services. Results: Of the 253 charts reviewed pre-intervention, seven individuals had a documented dementia diagnosis. No newly diagnosed patients were identified. Post-intervention, 10 individuals had a documented dementia diagnosis. One patient had findings of new cognitive impairment based on Mini-Cog testing and was referred for further dementia work-up. There was no documentation of referrals to community resources. Significance: Although the educational session raised awareness among providers of the importance of using cognitive screening tools routinely during AWV to improve early identification of dementia, changing practice requires a longer period of time. However, this project improved interprofessional collaboration between the hospital, primary care office, and Alzheimer’s Association.