Date of Publication
2024
Project Team
Mary Val Palumbo DNP, APRN, GNP-BC; Dr. John Steele Taylor, MD
Abstract
Purpose: To achieve the Healthy People 2030 goal of reducing preventable hospitalizations in older adults with dementia from 23.5% to 19.1%, this project implements the evidence-based UCLA Alzheimer’s and Dementia Care acuity classification system at an academic medical center’s memory program. The system will assist the dementia care specialist in improving dementia care quality and minimizing potentially preventable hospitalizations.
Methods: A retrospective chart review and clinician reassessment at patients’ follow-up appointments were conducted over a six-month period utilizing a SMART phrase containing the acuity classification questions which categorized dementia patients as low (green), intermediate (yellow), or high (red) risk for hospitalization.
Results: After implementation, 64% (n=57) of initially classified patients were reevaluated, with 63% (36) reclassified as green and 37% (21) as yellow. Six patients were initially determined to be red, with three lost to follow up and three reassessed as yellow due to decreased emergency department visits and behavior changes. Yellow and red patients had more emergency department visits and falls, need increased supervision, and their caregivers’ report higher stress and more safety concerns. Caregiver stress correlated with acuity, as 76% (16) of yellow patients’ caregivers reported moderate to severe stress compared to 17% (6) for green patients.
Conclusion: This project provided baseline information for a memory program transitioning towards a more comprehensive dementia care model, but could benefit from extended data collection to further investigate its effects on potentially avoidable hospitalizations, investing in a designated dementia care specialist, and initiatives to reduce caregiver stress for future care improvement.
Document Type
Dissertation/Thesis
Recommended Citation
Weisheit, Caroline, "Improving Dementia Care: Establishing an Acuity Classification System" (2024). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 152.
https://scholarworks.uvm.edu/cnhsdnp/152