Cognitive screening in persons with an amputation: a retrospective medical record audit
Erinn Dawes1, Vida Bliokas3,4, Lyndel Hewitt2,4, Val Wilson2,51Illawarra Shoalhaven Local Health District, Port Kembla Hospital, Warrawong, NSW, Australia2University of Wollongong, Faculty of Science, Medicine and Health, Wollongong, NSW, Australia3University of Wollongong, School of Psychology, Wollongong, NSW, Australia4Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia5Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW, Australia
Abstract
Background: Australia has the second highest rate of lower-limb amputation as a complication of diabetes in the world. Furthermore, it has been reported that being male or older than 60 years will increase the risk of undergoing amputation. This is of concern as the literature suggests that presence of cognitive impairment in persons with vascular conditions such as diabetes is a risk factor for dementia.
Objective: The purpose of this audit was to investigate the level of adherence to the cognitive screening component of the ACI guidelines for the care of a person following amputation in a local health district of NSW, Australia, and to determine the demographics of the sample.
Study design: Retrospective medical record audit.
Methods: The medical records of a convenience sample of persons who had undergone amputation; upper and lower limb, from one local health district were reviewed. The sample date range was between January 1st 2017 and December 31st 2018. The incidence and type of cognitive screening were also recorded. Descriptive statistics were used to describe the results.
Results: A total of 178 episodes of amputation care were identified during retrospective medical record auditing (mean age 69.7 years). Thirty nine of the 178 (21.9%) episodes of care had a cognitive screening measure completed during that inpatient admission (24.2% vascular aetiology, 12% non-vascular aetiology). All cognitive screens were completed in persons with lower limb amputations and were completed post-operatively.
Conclusion: Cognitive screening is not a routine part of the healthcare journey patients with an amputation in this healthcare district.
Biography
I completed my Master of Physiotherapy in 2012 and have spent the subsequent 10 years working in Aged Care, being familiar with both ward and community-based work. Community based work has provided a unique insight into the challenges patients discharged from hospital face at home and integrating into the community. My area of interest is amputees, and this has led me back into the world of academia, commencing a Philosophical Doctorate in 2019.