Formal Project Proposal
Introduction
Geriatric patients make the most delicate and unique population to take care of even in the clinical settings. Starting from assessment, it calls for multiple attentions from the care giver before coming up with the right diagnosis which will help in delivering appropriate care beneficial to the patient (Boltz, 2016). This is in line with the fact that geriatrics’ health is influenced by various aspects of life among them: physical, Cognitive, social, environmental and even emotional aspect. All the aspects are equally important and call for a keen and thorough assessment of each one of them, for one to identify the etiology of the condition the geriatric patients present with. A mental Status is a special tool when assessing and giving care to the geriatric patients that is often overlooked by clinicians. In most instances, the Mental Status Examination is carried out in individuals suspected to suffer from mental conditions, yet it is also a special tool to be used when attending to every aged patients. Determination of the Mental Status not only can tell the etiology of the patient but can also indicate the level of satisfaction of the care received by the aged. This article tackles on how mental status examination can be used effectively to determine loneliness and boredom in a geriatric patient during an assessment.
The Spirit of Inquiry Ignited
In the presence of a spirit of inquiry there is continued curiosity and research to find out even better evidence that will guide clinical practices, and care providers will be more likely to embrace Evidence-Based Practice. In this way, clinicians will develop questionsconcerning the evidence that supports their practices in the course of delivering their services. Instead of spending a lot of time doing routine practices, the caregiver will participate more in doing practices that are approved through research hence are grounded on evidence. Development of a spirit of inquiry amongst all caregivers will make use of Evidence-Based Practices a culture. When clinical decisions will be made based on Evidence from Research, existing theories and patient preferences and values, high quality of patient will be achieved. Health care institutions ought to uphold a culture that insists on Evidence-Based Practice and support clinicians providing them with tools that they need to provide care based on Evidence. This will involve sponsoring them and giving them opportunities to be involved in researches, within or outside the facilities, aimed at solving identified gaps during practice. By recognizing that Evidence-Based Practice is a problem-solving tactic, it will be well embraced and made a culture, even through policies, in the delivery of health care in health care centers.
Some of the factors may play as a hindrance in the ignition of a spirit of inquiry. Among them include insufficient knowledge and skills on Evidence-Based Practice inadequate preceptors to work hand in hand with caregivers when initiating new practices, inadequate resources and time especially in the case of staff shortage and high patient turn up.
The PICOT Question Formulated
In geriatric patients how is mental status examination more effective than clinical observation at preventing loneliness and boredom during the patient assessment?
The target population/ patient(P) is aged patients, Intervention(I) involved is a mental status examination, in Comparison(CO) is the clinical observation, lastly, the Timing(T) is during patient assessment.
Search Strategy Conducted. Critical Appraisal of the Evidence Performed
Clinical observations focus on the abnormal presentations in the aged. Conduction of Mental Status Examination in the aged does not only focus on the mal-presentations manifested through signs and symptoms but gives a wide view of all changes that have occurred(Feng et al., 2017). Some may be related to pathological process and some are normal changes that are expected as the person ages. This gives a clear understanding of the changes that the geriatrics present with during assessment. The clinician is able to identify the etiology behind and come with correct diagnosis and intervention. In the course of taking a clinical history of the patient, clinicians come up with differential diagnoses which can be further be narrowed down to a final diagnosis by observations made when conducting Mental Status Examination.
Research shows that up to approximately 60% of older patients suffer from either primary or secondary mental sign or symptom. This can be related to either cognitive, behavior or emotion where boredom or loneliness lies. Hence there is every need for compulsory assessment of the psychological and neurological function in every older patient who presents to the health care facility, regardless of the chief complaint. By examination of the mental status, one can determine the necessary laboratory, imaging and even specialized assessments and care that are needed to provide comprehensive care to the patient.
Evidence Integrated with Clinical Expertise and Patient Preferences to Inform a Decision and Practice Change
Mental Status Examination, especially among the old, is a practice that is founded on evidence from clinical Expertise and patient preference. It was found out to be more beneficial to the geriatric patient, there is need for thorough mental status examination, hence valued by the clinicians and boosts the care they give. Doing Mental Status Examination gives ground for the clinical caregiver and the aged patient to interact. It gives a clear understanding between the two parties and at the long haul, cooperation is at maximum. This is the case especially when the old can respond. The geriatric patients also can get a chance to share about their choice of care during a mental examination, hence the clinician will ensure the care the patients get is according to their wishes. Experts recommend mental status examination in the old because it also contributes to the level of counseling and education given to the patient and the family(Corey, 2015). The family appreciates more when advised on the best care for their old one. This can only be achieved through carrying out of a comprehensive mental status examination.
Implemented
With the healthcare sector in the nation shifting its attention to the geriatrics, which is rapidly expanding population due to improved quality health services, mental status examination is more embraced than just clinical observations. This is because the geriatric patients are the most vulnerable population due to both natural degeneration of the body and pathological processes. In the course of assessment of a geriatric patient, research points out that Altered Mental Status (AMS) often indicates the underlying condition (McGee,2016). As the concept of evidence-based is advocated for, a mental status examination is widely campaigned for and is picking up among most caregivers. It is mandatory in most developed facilities hence it has been adopted as a culture. More researchers are coming up based on the subject to bridge the gap that exists as a result of lack of evidence-based information. More funds are directed towards support of the same researchers and projects. The concept of practicing Evidence-Based Practice through mental examination in the old, is also incorporated into the curriculum for those learning to become future clinical practitioners.
Outcome Evaluated
Evaluation of the outcome of the benefits of carrying out of mental status examination has been carried out at various levels. There is continuous assessment of patients’ outcome in the health facilities by clinicians in the course of care. When carrying out researchers, caregivers evaluate the outcomes of the aged patients in the facilities who were done a mental examination during general assessment, in the course of conducting their internal or even external researchers. The outcome of the old patients, who are assessed their mental status in the course of general assessment, is far much better than those whose diagnosis relied on clinical observations (Dreger& Powers, 2017). The outcomes are better in line with correct diagnoses being made and appropriate care is given. More patients and families are starting to embrace the new trend as they have understood and seen the good outcomes of mental assessment.
Project Dissemination
The information is far wide spread in various forums. Through the media, the concept of incorporating comprehensive mental examination among the old is advocated for. Not only the clinicians but also the entire population is enlightened on the benefits of mental examination and everybody is pushing for the same despite hindrances here and there. Through printings: posters in health care centers and books the knowledge concerning mental examination is spread. In the seminars and workshops where continuous medical education is given out, mental status examination is among the discussed topics that are really advocated for especially among the old. Through the social media, the health care providers reach out to the people to go for mental checkup whether sick or healthy. This helps in the location of onset time and duration of a mental condition in case it occurs. The exercise is mostly advocated for in the elderly because of their age related psychological and mental changes that occur with time. With this they can be monitored closely and appropriate care started in time. Clinicians are also able to talk one on one with the patients and the family members on the significance of the practice especially on the old patients. Public health workers are also spreading wide the knowledge concerning mental health status examination through the local groups.
Conclusion
The significance of the mental status examination over basing diagnosis of an aged patient on clinical observations cannot be overemphasized. There is need to support more researchers to support this idea and practice especially through the participation of caregivers. The state and those in power in the healthcare facilities should push towards making this a culture in the healthcare facilities amongst caregivers. It is among the evidence-based practices that cannot be underrated. Though the outcomes, the patients will learn to value it more and make it among their preferences in the course of the assessment. It will enable the aged patients to receive comprehensive holistic care contributing to the general wellbeing of geriatric patients who are the most growing population.
References.
Boltz, M., Capezuti, E., Fulmer, T. T., &Zwicker, D. (Eds.). (2016). Evidence-based geriatric
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Corey, G. (2015). Theory and practice of counseling and psychotherapy. Nelson Education.
Dreger, S. M. D., & Powers, J. S. (2017). 7. Caring for Older Adults. Catholic Witness in Health
Care: Practicing Medicine in Truth and Love, 261.
Feng, M. A., McMillan, D. T., Crowell, K., Muss, H., Nielsen, M. E., & Smith, A. B. (2015).
Geriatric assessment in surgical oncology: a systematic review. journal of surgical
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McGee, S. (2016). Evidence-Based Physical Diagnosis E-Book. Elsevier Health Sciences.
