Standardizing the screening, assessment, and treatment of mild cognitive impairment in acute care: a multidisciplinary approach
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With an estimated prevalence of rate of 18.9% in the general population and 25% to 80% in individuals with heart failure (HF), mild cognitive impairment (MCI) results in impaired executive functioning, hospital readmissions, and increased utilization of the healthcare system (Alagiakrishnan, et al., 2017; Amini, et al., 2019). Studies suggest these cognitive impairments are often unidentified or undiagnosed (Amini, et al., 2019; Zhuang, et al., 2019). Despite the established effects of MCI and cognitive impairment in the hospitalized population, there are gaps in the research regarding a standardized approach to addressing this problem (Cameron, et al., 2017; Zhuang, et al., 2019). Currently, there are no effective pharmacological interventions that offer a long-term effect on delaying the progression from MCI to dementia. There is, however, a growing body of evidence supporting the important role of non-pharmacological interventions in MCI (Hong, et al., 2015; Sherman, et al., 2017). OTs have the skills to provide cognitive rehabilitation including global learning strategies, specific functional skills training, use of external aids, and cognitive retraining during functional activities, therefore, a standardized protocol was developed to benefit OTs and patients they are treating. The Multidisciplinary Approach for MCI has three key components: 1) educating nurses on how to assess for MCI and cognitive impairments, including how to provide cognitive stimulation daily and when to consult occupational therapy to optimize care, 2) standardizing an approach for OTs on how to screen, assess, and treat MCI and cognitive impairment in acute care and 3) increasing awareness of OT’s role within an interdisciplinary team to address MCI and cognitive impairments in acute care. This protocol aims to be a feasible and affordable method to educate nurses and OTs on how to treat MCI and cognitive deficits in acute care. Dissemination of this program is essential to its success. With more OTs implementing this program, the greater the opportunity for critical evaluation and refinement. The focus of this project was on the initial education and feasibility of the Multidisciplinary Approach for MCI, however the potential impact of its use to improve patient outcomes in the future is encouraging.
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