The Edinburgh Feeding Evaluation in Dementia Scale: determining how much help people with dementia need at mealtime.

OVERVIEW: The Edinburgh Feeding Evaluation in Dementia scale is an 11-item instrument developed to assess eating and feeding problems in people with late-stage dementia. By looking for certain behaviors--spilling food while eating or turning the head when prompted to eat, for example--a nurse can identify a patient's needs and build an effective care plan. The scale takes as little as five minutes to complete. Watch an online video of nurses demonstrating the use of the scale: http://links.lww.com/A281.

Initial steps taken by nine primary care practices to implement alcohol screening guidelines with hypertensive patients: the AA-TRIP project.

Many medical conditions are caused or exacerbated by heavy drinking, necessitating alcohol screening and discussion in primary care practices. This is particularly true of hypertension, the most common primary diagnosis in the United States, which has been linked to the regular consumption of 3 or more standard alcoholic beverages a day. The Accelerating Alcohol Screening-Translating Research into Practice (AA-TRIP) project was designed to improve detection and management of alcohol problems in primary care patients with hypertension. Medical providers are being trained using the Practice Partner Research Network's- Translating Research into Practice (PPRNet-TRIP) quality improvement model. This includes a multi-method intervention (electronic medical records, on-site academic detailing, practice feedback reports and annual network meetings) to help practices increase adherence to clinical guidelines. Qualitative analyses of initial steps taken by nine primary care practices toward the routine implementation of alcohol screening guidelines are presented. Organizational factors and provider and patient characteristics all influenced the method and consistency of alcohol screening and intervention. Perceived time constraints, patient sensitivity to questions about alcohol, and possible stigma associated with a diagnosis of alcoholism were also relevant barriers requiring problem solving.