Quality Improvement in a Community-Based Dementia Clinic

Abstract Early symptoms of dementia can be difficult to identify in nonspecialized settings, and longer symptom duration before diagnosis coincides with greater severity of impairment. Proactive assessments and supportive interventions for patients with memory deficits can improve quality of life and are supported by the American Academy of Neurology. This quality improvement project assessed the impact of an advanced practice nurse implementing a standardized screening on patient satisfaction, quality of life, and caregiver strain. Twelve patient/caregiver dyads were recruited from a community-based neurology practice. The advanced practice nurse performed comprehensive cognitive and functional assessments and evaluated patient satisfaction, quality of life, and caregiver strain before and after the visit. The patient cohort ranked their quality of life higher than midline both before and after the clinic visit, although slightly lower after. Most care partners initially rated their strain as high; postvisit results indicated a 41% decrease. Satisfaction improved or remained stable on most patient questions and care partner surveys. This quality improvement project demonstrates advanced practice nurses are positioned to improve postdiagnostic care to reduce the burden of this devastating disease.