Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Geriatric Rehabilitation
To determine the significance of depression screening within the geriatric acute inpatient rehabilitation population
A quasi-experimental design using a convenience sampling of patients 65 years or older admitted February 8, 2017 through February 28, 2017 and from September 7, 2018 through November 7, 2018
Setting : DCH Rehabilitation Pavilion in Northport, AL; a community hospital setting with 41 acute inpatient rehabilitation beds
Participants (or Animals, Specimens, Cadavers) :
A convenience sample of 102 patients aged 65 years and older were considered. Of these, 89 patients were eligible to participate based upon ability to answer yes/no questions with at least 75% reliability per ST evaluation. 23 of the 102 patients were included in the February 2017 sample; 1 patient was excluded. 65 patients were included in the September-November 2018 sample; 13 patients were either missed or ineligible and excluded from the sample.
Interventions : In total, 89 patients were assessed using the 15 item Geriatric Depression Screen (GDS). A score of 5 or greater would be counted as a “positive” depression screen and warrant clinician follow-up or intervention. X2 analysis was used to test reliability of the 2 sample results by showing that the number of positive or negative results were not associated with a specific sample year. The total number of positives were then compared through binomial analysis with the expected 30% in order to determine prevalence of depression and significance of depression screening on the unit.
Main Outcome Measure(s) : It was estimated that 30% of geriatric rehab patients were at risk for depression. If around 1/3 of our patients were at risk, then a standardize screening tool needed to be implemented.
The 2017 sample resulted in 8/23 positives (34.7%) . The 2018 sample resulted in 22/65 positives (33.8%). X2 analysis did not reflect an association between the two sample years and specific results, X2 (1)= 0.002, p = 0.964, meaning both samples results were similar or reproducible. A binomial test indicated that the proportion of positive GDS screens of 0.3 was high/equal to the expected 0.30, p=0.256 (1-sided). Ultimately, around 1 out of 3 patients tested positive as at least “at risk for depression”.
Around 1/3 of geriatric patients tested “at risk” or “suggestive of” depression. Resultantly, appropriate follow-up & treatment were provided.
Tiffany Wood– Basic Medical Science Liaison, DCH Rehabilitation Pavilion, Northport, Alabama
Kayla Glass– CRNP, RSP: The Physiatry Group, Northport, Alabama
Christy Rowland– CRNP, DCH Rehabilitation Pavilion, NORTHPORT, Alabama
James Barnett– Medical Director, Northport Rehabilitation Pavilion, Northport, Alabama