Developing A Decision Tree To Address Behavioral And Psychological Symptoms Of Dementia In The Primary Care Setting

<p>AbstractDeveloping a Decision Tree to Address Behavioral and Psychological Symptoms of Dementia in the Primary Care Setting There are 55 million people living with dementia worldwide. In the United States, there are approximately 7.2 million people living with Alzheimer’s dementia and these numbers are expected to rise. The U.S. Department of Health and Human Services (2022) identified there is a shortage of behavioral health clinicians nationwide. As the population ages, demand for behavioral health clinicians will be high and supply will remain low. Primary care providers (PCPs) will be required to see an influx of dementia patients despite finding it challenging to manage behavioral and psychological symptoms of dementia (BPSD). This DNP quality improvement project addressed this concern by developing a decision tree to manage complex and challenging behaviors in two geriatric primary care practice settings in Arizona. After a comprehensive review of the literature, the decision tree content was developed. A panel of six experts reviewed the decision tree for relevance, useability, and best practice. Five PCPs participated in the DNP project over a 10-week period. Nine patient participants were enrolled in the DNP project and four out of nine participants had pre-and-post follow-up visits and were urgent cases. Patients received an initial visit and a follow up visit within 2-8 weeks. The CGI scale was used with each use of the decision tree. Paired samples t-test examined if there was a significant change in CGI score between initial visit and follow-up visit. No statistically significant change was found, (t(3) = 1.36, p = .252), likely due to a small sample size. However, the effect size was large (Cohen’s d = 1.00), suggesting with a larger power sample the change could reach statistical significance. This DNP project identified that PCPs find the decision tree beneficial to guide their practice. The decision tree also has the potential to improve best practice among PCPs in the management of BPSD. In addition, there is a strong need for a decision tree to manage BPSD in clinical practice. </p>

Name thesis:degree_name

Doctor of Nursing Practice (DNP)

Level thesis:degree_level

Open Access Thesis

Discipline thesis:degree_discipline

Yale University School of Nursing

Year

2025

Author dc:creator

• Tramel, Lolita

Contributors dc:contributor

• Carissa Tufano

Repository record dc:identifier

https://elischolar.library.yale.edu/ysndt/1206

OAI identifier oai:identifier

oai:elischolar.library.yale.edu:ysndt-1205