Abstract
Background
Pop-Up Digital assessments utilising screening tools such as the 4AT could been seen as a method to improve early diagnosis.
The aim of this project is to improve the use of the 4AT through a redesigned pop-up Delirium Assessment, and to see whether its use would improve following raising awareness though ‘Dementia Action Week’.
Methods
Thirty patients' medical records from emergency admissions containing the medical coding criteria ‘Confusion’, ‘Delirium’, and ‘Dementia’ were included for each cycle. Patients under 65, and those admitted for less than 24 hours were excluded. The delirium assessments were reviewed alongside the clinical notes to determine whether the assessment had been completed appropriately.
The first cycle reviewed the use of the existing Delirium Assessment Tool before any intervention. Further data was collected after the implementation of the redesigned assessment tool, and following ‘Dementia Action Week’ which involved general communications around dementia, but also some teaching on the wards around the use of the 4AT.
Results
The initial data showed 39 delirium assessments were completed in total for the cohort of 30 patients, with the 9 additional assessments resulting from a ‘defer’ option. Overall, 23% of delirium assessments were completed correctly, with a documented 4AT.
Following the redesign of the assessment, there were 46 delirium assessments completed, of which 30% were completed correctly.
After raising awareness through ‘Dementia Action Week’ there were 35 assessments completed, of which 63% were completed correctly.
Conclusion
The findings from the initial cycle of this project suggest that pop-up assessments tools are often not completed correctly.
The increased percentage of accurately completed Delirium Assessment Tools through the second and third cycles of data collection might suggest their effective use depends on how they are designed and their concision.
Comments
This is a really interesting…
This is a really interesting project showing how relatively small changes like redesign and raising awareness can significantly improve the completion rates of delirium assessments. I like how you demonstrated the progressive impact through each intervention cycle.
Do you think the improvements were more down to the redesign of the tool itself, or the awareness campaign, and how might you separate their effects in future?
Delirium Assessment Tool Interventions
I suspect there is an element of "pop-up" fatigue in these results. Therefore it is probably the synergism of both of these interventions contributing to the improvement in appropriately completed assessments.