Electronic Data Collection for Serial Geriatric Assessment

Monday, 7 July 2008
Sonia Sandhaus, MS, RN, CRNP , Hospital Elder Life Program, Moses Taylor Hospital, Scranton, PA
Margarete Lieb Zalon, PhD, RN, APRN, BC , Department of Nursing, University of Scranton, Scranton, PA
Donna Valenti, RNC , Hospital Elder Life Program, Moses Taylor Hospital, Scranton, PA

Learning Objective 1: Identify considerations in facilitaing electronic data collection in acute care settings.

Learning Objective 2: Describe the utility of frequent mental status and delirium assessment for clinical practice.

Delirium in hospitalized elderly is associated with longer length of stay, greater likelihood of nursing home placement, depressive symptoms, functional decline, and mortality after hospitalization. Early detection of delirium through frequent assessment has the potential to facilitate earlier treatment and prevention of long-term consequences.

The aim is to develop an electronic data collection methodology, Serial Assessment For Elders (SAFE), in order to 1) evaluate patient outcomes, 2) screen for depression, 3) screen for delirium, and 4) evaluate serial mental status assessments in preventing delirium and/or cognitive decline in hospitalized elders.

The Hospital Elder Life Program (HELP) (Inouye, 1999) is a research-based program designed to prevent cognitive decline in the hospitalized elderly. Testing and technological support for electronic collection of geriatric assessment data routinely collected by the HELP program would facilitate monitoring of patient outcomes.

The sample will consist of patients aged 70 and older admitted to the HELP program over a four-month period. It is estimated that 300 patients will be enrolled during this time frame. The HELP staff conduct initial and ongoing assessments of patients referred to the program including a depression screen, mental status assessment and confusion assessment. Data will be collected with personal digital assistants (PDA) and downloaded into a secure computer.

Data analysis will include 1) determining whether patients who screened positively for depression had a higher incidence of delirium and/or cognitive decline, 2) comparing changes in scores on the MMSE for those patients who remained free of delirium with those who developed delirium or had a resolution of delirium since admission and 3) determining the relationship between the incidence of delirium and gender, age, length of stay, and discharge disposition.

Preliminary results will be reported. Strategies to facilitate the use of PDAs for ongoing assessment, data collection and program evaluation will be described.