Implementing the Abnormal Involuntary Movement Scale AIMS As an Evidence Based Practice Screening Tool in Adult Patients Taking Antipsychotics to Detect and Treat Tardive Dyskinesia

Abstract

Background: Tardive Dyskinesia (TD) is possibly a permanent involuntary movement condition that is caused by all antipsychotics including atypical antipsychotics and typical antipsychotics. TD is also a socially stigmatizing disorder. The most recommended management strategy for TD is prevention. Objective: The aim was to improve quality of care for patients with the implementation of the Abnormal Involuntary Movement Scale (AIMS) as a screening tool in adult patients aged 18 to 65 years old taking antipsychotic medications. Methods/Design: This was a quality improvement project. A total of 60 adult patients were recruited but only 40 participated in the quality improvement project. The Abnormal Involuntary Movement Scale as a screening tool was implemented in the outpatient private practice from September 15 through November 16, 2018. The screening tool was implemented by the Doctor of Nursing Practice (DNP) student during each patient visit, followed by a review of scores to increase screening for TD. The DNP student was able to improve patient outcomes by identifying TD and making referrals for treatment. The World Health Organization Quality of Life instrument (WHOQOL-BREF) was used to assess the quality of life of patients taking antipsychotics. Results: The implementation of the AIMS in the routine monitoring for TD in adult patients improved patient outcomes with detection and treatment of tardive dyskinesia in adult patients taking antipsychotic medications with increased screening protocol from 0% to 80% within 12 weeks. The WHOQOL-BREF assessed the quality of life of adult patients taking antipsychotics and did not indicate any changes in the quality of life of patients. Conclusion: Implementing the AIMS improved quality of care in adult patients taking antipsychotics in the outpatient private practice.

Increasing Abnormal Involuntary Movement Scale (AIMS) Screening for Tardive Dyskinesia in an Outpatient Psychiatry Clinic: A Resident-Led Outpatient Lean Six Sigma Initiative

“…The Tardive Dyskinesia Assessment Working Group suggests that the AIMS is a valid assessment tool for TD both for research and clinical practice but does not report data on improvement in screening rates. A 2019 study reported an increase in AIMS implementation from 0% to 80% in 12 weeks in an outpatient private practice when the scale was administered by a Doctor of Nursing Practice (DNP) student during each patient visit [ 10 ]. However, the goal of the study was to identify TD and involved a single researcher administering AIMS to each patient to study improvement in patient outcomes and used the Plan-Do-Study-Act QI model.…”