Language

English

Publication Date

8-1-2025

Journal

Journal of the American Geriatrics Society

DOI

10.1111/jgs.19578

PMID

40515731

PMCID

PMC12396171

PubMedCentral® Posted Date

6-14-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Several strategies have been proposed to increase chronic cognitive impairment (CI) screening in the emergency department (ED). Our goal was to assess the feasibility and acceptability of implementing specific CI screening tools and strategies in the ED from an ED registered nurse and technician perspective.

Methods: We performed a qualitative study using semi-structured interviews with a purposive sample of ED nurses and ED technicians (EDTs). Participants worked at an urban academic hospital and were interviewed between November 2023 and March 2024. Interviews assessed participants' opinions on the feasibility and acceptability of CI screening and the use of machine learning (ML) tools to identify high-risk patients for targeted CI screening, tablet-based screenings, and two validated CI screenings: the Ottawa 3DY (O3DY) and Short Blessed Test (SBT). We used the Consolidated Framework for Implementation Research (CFIR) to develop our interview guide and performed a rapid analysis with deductive and inductive codes based on CFIR constructs.

Results: Four major themes related to CI screening tools arose: (1) Benefits of CI screening; (2) feasibility of integrating screening tools into existing workflows; (3) professional role limitations; and (4) implementation requirements. Participants perceived CI screening as important for allocating limited ED resources. Shorter, less specific testing, including the O3DY, was seen as feasible during triage, while longer, more specific screening, including the SBT, was seen as more feasible in roomed care areas. Both ED nurses and EDTs identified the need for electronic health record tools and dedicated screening teams to facilitate implementation.

Conclusion: ED nurses and EDTs support chronic CI screening if screening techniques and clinical teams can be optimized to make workflows feasible.

Keywords

Humans, Emergency Service, Hospital, Female, Male, Qualitative Research, Cognitive Dysfunction, Mass Screening, Feasibility Studies, Middle Aged, Interviews as Topic, Adult, Aged, Attitude of Health Personnel, Machine Learning, cognitive impairment, emergency medicine, machine learning, qualitative research, screening

Published Open-Access

yes

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