Date of Conferral

5-26-2025

Date of Award

May 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Deborah Lewis

Abstract

The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided this project. Databases were searched for literature published from 2010 to 2024. Five papers involving a VA patient population were identified from an initial pool of 50 and analyzed for psychometric data and criteria using the PEO framework. Sensitivity was reported for three tools, VA Medical Center Saint Louis University Mental Status (VAMC SLUMS; 0.742), Montreal Cognitive Assessment (MOCA; 0.677), and the Short Test of Mental Status (STMS; 0.613), respectively. The Clock Drawing Test (CDT) and Trail Making Test (TMT) had high specificity and variable sensitivity. MCI detection data were not available for the Mini Mental State Examination (MMSE) and Rapid Cognitive Screen (RCS). Dementia detection data were available for the MMSE only. Cognitive screening tools developed for, or validated in, the VA environment, such as the VAMC SLUMS exam and the RCS, align more closely with the operational and demographic needs of veteran care. The implications for nursing practice and social change are that the use of a preferred BCS tool for the VA outpatients may lead to improved detection of MCI and dementia.

Download

Included in

Nursing Commons

Share

 
COinS