Neurocognitive Disorders Comprehensive nursing paper example

Neurocognitive Disorders Comprehensive nursing paper example

DSM: Delirium

Instrument: Mini-Mental Status Exam (MMSE)

Article: The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis.

Appropriateness for Dx: The Mini-Mental State Examination (MMSE) evaluates an individual’s mental status (Mitchell, Shukla, Ajumal, Stubbs, & Tahir, 2014). Significantly, the MME is appropriate for screening individuals with high chances of having delirium (Mitchell et al., 2014). Remarkably, the MMSE is an effective assessment tool for neurocognitive impairment among the hospitalized and institutionalized elderly patients and community dwellings. (Neurocognitive Disorders Comprehensive nursing paper example)

Response to Therapy/Treatment: The MMSE is designed to be administered in a clinical setting by psychotherapists.The MMSE is an effective tool for screening patients for various neurocognitive impairments (Arevalo‐Rodriguez et al., 2015). The MMSE assessment process takes approximately 10 minutes; thus, it can be done repeatedly and routinely to ascertain a diagnosis. In addition, the instrument can measure significant changes in individuals mental status to guide appropriate intervention.(Neurocognitive Disorders Comprehensive nursing paper example)

Psychometrics: The MMSE is an 11-item instrument that measures the core areas of cognitive function, i.e., recall, language, registration orientation, and attention, with an optimum score of 30 (Heart and Stroke, n.d). The higher the score, the lower the degree of cognitive impairment, while a score below 23 is a clear indication of cognitive impairment. Thus, the MMSE has a higher internal validity, high sensitivity and specificity. Thus, the MMSE has an appropriate predictive validity and moderate internal consistency (Mitchell et al., 2014).(Neurocognitive Disorders Comprehensive nursing paper example)

Limitations:  The MMSE has significant limitations. The instrument depends on verbal response, including reading and writing (Arevalo‐Rodriguez et al., 2015). Thus, it cannot be used with patients with visual or hearing impairments and limited English comprehension. Equally, the instrument can not be used as a confirmatory test, yet it can screen out the possibility of having delirium (Mitchell et al., 2014).  Moreover, the MMSE can not diagnose a case for neurocognitive impairment and should not be a replacement for established mental health clinical assessment. (Neurocognitive Disorders Comprehensive nursing paper example)

References

Arevalo‐Rodriguez, I., Smailagic, N., Figuls, M. R., Ciapponi, A., Sanchez‐Perez, E., Giannakou, A., … & Cullum, S. (2015). Mini‐Mental State Examination (MMSE) for detecting Alzheimer’s disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database of Systematic Reviews, (3). 10.1002/14651858.CD010783.pub2

Heart and Stroke. (n.d.). Allen-Huang-cognitive-screening-toolkit. Retrieved 1 August 2021, from https://www.heartandstroke.ca/-/media/pdf-files/canada/clinical-update/allen-huang-cognitive-screening-toolkit.ashx?la=en&hash=631B35521724C28268D0C2130D07A401E33CDBB0\

Mitchell, A. J., Shukla, D., Ajumal, H. A., Stubbs, B., & Tahir, T. A. (2014). The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis. General hospital psychiatry, 36(6), 627-633. https://doi.org/10.1016/j.genhosppsych.2014.09.003