Embedding audiological screening within memory clinic care pathway for individuals at risk of cognitive decline-patient perspectives.

BACKGROUND: With the evolving knowledge on hearing as a potentially modifiable mid-life risk factor for dementia, identification of people at risk becomes increasingly important. People with mild cognitive impairment (MCI) presenting to specialist memory services represent a key "at-risk" target population for audiological evaluation, but few services have established this pathway. This study sought to examine the patient experience and understanding of this process. METHODS: All patients with MCI attending a tertiary referral memory service referred for audiology review were contacted. A patient survey was delivered over the phone. Outpatient letters and the memory clinic database were reviewed. RESULTS: Twenty patients with MCI were included in the survey. Eight (8/20, 40%) had self-reported hearing loss. Upon formal audiological assessment seventeen (17/20, 85%) had objective evidence of hearing loss; nine (9/17, 52.9%) with mild-moderate and eight (8/17, 47%) with moderate-severe hearing loss. Only six patients (6/20, 30%) recalled having the rationale behind having a hearing test as part of their memory work-up explained to them. However, the majority (15/20, 75%) felt a hearing test was an important part of their memory assessment. Just seven patients overall (7/20, 35%) identified a link between hearing-loss and cognition. All patients who provided feedback on the service itself made positive comments, although (4/20, 20%) felt they did not get adequate information about the results. CONCLUSIONS: A significant proportion of people with MCI had de-novo evidence of hearing impairment upon assessment. Patients are satisfied with incorporating audiological evaluation into a memory clinic assessment, however clear communication around indication, recommendations, and follow-up ensuring compliance is required.

Impact of embedded librarianship on undergraduate nursing students' information skills.

BACKGROUND: One-shot library sessions have numerous drawbacks; most notably, they rarely have a long-term impact on students' research behavior or skill sets. Library literature notes that when students interact with an embedded librarian, their skills improve. While close partnerships with subject faculty are important, librarians must also assess students' skill sets to determine the impact of these teaching efforts. CASE PRESENTATION: During the course, the embedded librarian used various activities and assignments to teach information-seeking skills, with the expected outcome of increased skill sets. This IRB-approved research project focused on measuring and assessing students' information-seeking abilities before and after interacting with the embedded nursing librarian. Changes in students' information fluency skills were measured using pre- and post-tests. CONCLUSIONS: The study results provide evidence of the benefits of the embedded librarianship model. Continued measurement of students' skills acquisition is important to enable librarians and library administrators to show the positive impacts the library has on student learning and success.

Implementation of a health surveillance clinic for children with Down syndrome.

The implementation of the multidisciplinary Down Syndrome Health Surveillance clinic at Children's Health Ireland at Tallaght, Dublin has shown significant improvements in the adherence to guidelines as well as providing health promotion strategies such as information on immunisations. Our project provides a framework which would be potentially emulated and used in other medical conditions. The reduction in clinic attendances and co-ordination of same-day appointments has improved parental satisfaction as well as the quality of care.