A Case Study Evaluation Protocol to Assess Processes, Effectiveness and Impact of a Nurse Practitioner-Led Memory Clinic

Abstract

The prevalence of dementia is predicted to increase significantly as the population ages and with no foreseeable cure options the burden of dementia will continue to grow. Early diagnosis provides many benefits, including timely access to appropriate support services and provision of tailored therapeutic interventions for people with dementia and their carers. Memory clinics are a key response to the need for specialist assessment and diagnosis of dementia. Multidisciplinary team memory clinics are considered the "gold standard"; however, such resource intensive clinics are likely unsustainable. The nurse-led memory clinic format may provide a primary care focused, diagnostic service for dementia that does not have the cost implications of multidisciplinary memory clinics but there is limited research using nurse practitioners. This study is exploring the potential of a nurse-led memory clinic as a primary health care approach to health promotion (brain health awareness), disease prevention (risk factor reduction) and early intervention (diagnosis and management of dementia). A realistic evaluation of a nurse practitioner-led memory clinic is described. Realistic evaluation is concerned not only with the outcomes of an intervention but also with the context and mechanisms of the intervention. We are using a mixed methods case study design to describe and evaluate the impact of the nurse practitioner-led memory clinic. The nurse practitioner in this study is an advanced practice aged care nurse who focuses on mental health, and dementia diagnosis, management and risk factor reduction. This study seeks to inform the development of an expanded scope role for nurse practitioners in assessment and referrals for dementia diagnosis. The heterogeneity of clients attending the nurse-led memory clinic will allow us to evaluate what works in the memory clinic, for whom, and under what circumstances, in what respects, and to what extent.

Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care

“…The case study has been referred to as an appropriate research strategy to enhance the phases and the transitions across the reflection and action phases ( 19 , 20 ). This strategy becomes particularly useful in health services research ( 21 ), particularly in this paper, to better evaluate the essential RPM-based follow-up services’ features to each relevant stakeholder and why in the context of cardiothoracic surgery ( 22 ).…”

Impact of Advanced Access Scheduling on Patient Care Choices and Health Behaviours in a Nurse Practitioner-Led Clinic

“…A review of literature did not reveal evidence of nurse practitioner led clinics that are developed, governed and managed by nurse practitioners where the NP works within a team approach, but is the primary care provider at the clinic site. Although there are numerous nurse and nurse practitioner-led clinics in a variety of countries across the globe, they tend to offer specialized care and not comprehensive primary healthcare (Shiu et al 2011;Murfet et al 2013;Bentley et al 2014). In addition, health system funding in some countries, specifically the US and in some respects the UK, is not congruent with the NPLC model implemented in Canada (Auerbach et al 2013;Hoare et al 2011).…”

Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles

“…The study received ethical approval from the Tasmania Health and Medical Human Research Ethics Committee. This was part of a larger study assessing processes, effectiveness, and impact of the NLMC with the full protocol published elsewhere (Bentley et al, 2014).…”