Date of this Version

12-4-2023

Document Type

DNP Project

Abstract

Background: The prevalence of neurocognitive disorders (NCDs) is expected to increase dramatically with an aging population. Although early detection of cognitive decline is beneficial for patients, care partners, and society, NCDs are frequently underdiagnosed in primary care settings worldwide. Primary care providers (PCPs) are ideally positioned to conduct cognitive screenings, but they encounter many barriers in assessing, diagnosing, and managing NCDs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to explore PCPs’ readiness for implementing a feasible, evidence-based approach for cognitive screening among older adults.

Methods: This DNP project utilized a descriptive cross-sectional study design. A survey was administered to a voluntary sample of PCPs in seven South Florida medical centers. The survey items explored PCPs’ perceptions for implementing a cognitive screening protocol among older adult patients.

Results: Of the 21 eligible participants, 20 PCPs completed the survey, a participation rate of 95%. The sample consisted of experienced medical doctors (n = 7) and advanced practice registered nurses (n = 13). Monthly, PCPs reported an average of 199.4 (SD = 99.7) encounters with older adults and newly diagnosing a mean of 20.2 (SD = 37.7) patients with mild cognitive impairment. Most (65%; n = 13) PCPs reported feeling comfortable evaluating and managing dementia. Although, 90% (n = 18) of PCPs reported they would evaluate more patients for dementia if they had access to a dementia clinical team and more time (80%, n = 16). Forty-five percent (n = 9) of the PCPs reported feeling discomfort in delivering “bad news” of a dementia diagnosis.

Conclusions: This DNP project explored PCPs’ perceptions for evaluating dementia symptoms among older adults in primary care. The key study findings included PCPs’ report of insufficient time to evaluate dementia and a lack of access to a dementia clinical team. Although, PCPs appear prepared to conduct dementia screening, organizational support to address time constraints and access to a dementia clinical team should be considered.

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