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Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital.

ABSTRACT: BACKGROUND:Cognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed by nonspecialists, such as nurses while featuring automatic scoring and interpretation of results. OBJECTIVE:This study validated a newly developed questionnaire for measuring the attitudes of Greek nurses towards computerized dementia screening. MATERIAL AND METHODS:The questionnaire was validated in a sample of 212 undergraduate psychology students and subsequently administered to a sample of 19 nurses working in a general hospital. Reliability of the questionnaire was calculated using Cronbach's alpha (=?0.762). Factor analysis revealed the existence of a single factor (acceptability-feasibility) that accounted for 33.73% of variance with an eigenvalue of 3.036. RESULTS:The total score of all the items loading on the single factor (acceptability-feasibility) was calculated. Scores ranged between 10 and 40 with the average score for the validation group being 29.33 (SD?=?4.89) and the average score for the nurses' group being 29.50 (SD?=?3.20). DISCUSSION:The questionnaire has acceptable reliability. Results indicate that acceptability-feasibility is high in both groups and there were no statistically significant differences between the two groups.

SUBMITTER: Zygouris S

PROVIDER: S-EPMC6821656 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital.

Zygouris Stelios S Gkioka Mara M Moraitou Despoina D Teichmann Birgit B Tsiatsos Thrasyvoulos T Papagianopoulos Sotirios S Tsolaki Magda M

Zeitschrift fur Gerontologie und Geriatrie 20191022 Suppl 4

<h4>Background</h4>Cognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed b ...[more]

PMID: 31641839

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Project description:AimsLittle is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care.MethodsCross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses.ResultsOverall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups.ConclusionsBPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as a wide range of special treatments needs and additional behavioural and medical complications. Management strategies are needed to improve the situation for both patients and hospital staff.

Project description:BackgroundVisits in emergency departments and hospital admissions are common among nursing home (NH) residents and they are associated with significant complications. Many of these transfers are considered inappropriate. This study aimed to compare the perceptions of general practitioners (GPs) and NH staff on hospital transfers among residents and to illustrate measures for improvement.MethodsTwo cross-sectional studies were conducted as surveys among 1121 GPs in the German federal states Bremen and Lower Saxony and staff from 1069 NHs (preferably nursing staff managers) from all over Germany, each randomly selected. Questionnaires were sent in August 2018 and January 2019, respectively. The answers were compared between GPs and NH staff using descriptive statistics, Mann-Whitney U tests and ?2-tests.ResultsWe received 375 GP questionnaires (response: 34%) and 486 NH questionnaires (response: 45%). GPs estimated the proportion of inappropriate transfers higher than NH staff (hospital admissions: 35.0% vs. 25.6%, p?<?0.0001; emergency department visits: 39.9% vs. 20.9%, p?<?0.0001). The majority of NH staff and nearly half of the GPs agreed that NH residents do often not benefit from hospital admissions (NHs: 61.4% vs. GPs: 48.8%; p?=?0.0009). Both groups rated almost all potential measures for improvement differently (p?<?0.0001), however, GPs and NH staff considered most areas to reduce hospital transfers importantly. The two most important measures for GPs were more nursing staff (91.6%) and better communication between nursing staff and GP (90.9%). NH staff considered better care / availability of GP (82.8%) and medical specialists (81.3%) as most important. Both groups rated similarly the importance of explicit advance directives (GPs: 77.2%, NHs: 72.4%; p?=?0.1492).ConclusionsA substantial proportion of hospital transfers from NHs were considered inappropriate. Partly, the ratings of possible areas for improvement differed between GPs and NH staff indicating that both groups seem to pass the responsibility to each other. These findings, however, support the need for interprofessional collaboration.

Project description:Background:Carbapenemase Producing Enterobacteriaceae (CPE) has spread rapidly and presents a growing challenge in antimicrobial resistance (AMR) management internationally. Screening for CPE may involve a rectal swab, there are limited treatment options for affected patients, and colonised patients are cared for in isolation to protect others. These measures are sound infection prevention precautions; however, the acceptability of CPE screening and its consequences are currently unknown.The aim of this study was 'To determine factors influencing acceptability of CPE screening from the perspectives of nursing staff and the general public.' Methods:National cross-sectional surveys of nursing staff (n?=?450) and the general public (n?=?261). The Theoretical Domains Framework (TDF) guided data collection and analysis. Regression modelling was used to identify factors that predicted acceptability of CPE screening. Results:For nursing staff, the following predictor variables were significant: intention to conduct CPE screening (OR 14.19, CI 5.14-39.22); belief in the severity of the consequences of CPE (OR 7.13, CI 3.26-15.60); knowledge of hospital policy for screening (OR 3.04, CI 1.45-6.34); preference to ask patients to take their own rectal swab (OR 2.89, CI 1.39-6.0); awareness that CPE is an organism of growing concern (OR 2.44, CI 1.22-4.88). The following predictor variables were significant for the general public: lack of knowledge of AMR (??-?.11, p?=?.01); social influences (? .14, p?=?.032); social norms (? .21p?=?.00); acceptability of being isolated if colonised (? .22, p?=?.000), beliefs about the acceptability of rectal swabbing (? .15, p?=?.00), beliefs about the impact of careful explanation about CPE screening from a health professional (? .32, p?=?.00).Integrating results from staff and public perspectives points to the importance of knowledge of AMR, environmental resources, and social influences in shaping acceptability. Conclusions:This is the first study to systematically examine the acceptability of CPE screening across nursing staff and the public. The use of TDF enabled identification of the mechanisms of action, or theoretical constructs, likely to be important in understanding and changing CPE related behaviour amongst professionals and public alike.

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Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital.

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Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital.

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