ArticleCureus2025
Enhancing Cognitive Impairment Assessment and Management in Hip Fracture Patients: A Two-Cycle Clinical Audit.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCognitive impairment significantly affects elderly hip fracture patients, dramatically worsening their outcomes, yet healthcare teams consistently fail to screen for it. Despite national guidelines mandating routine cognitive assessment, compliance remains alarmingly low. This audit confronted this critical gap between evidence and practice in fragility hip fracture care. Methods: We conducted a prospective two-cycle audit at Northwick Park Hospital in Harrow, England, to transform cognitive assessment practices. Cycle 1 (July-November 2023) exposed baseline failures in 30 patients aged ≥65 with fragility hip fractures. With these insights, we deployed a multifaceted intervention: electronic alerts that could not be ignored, intensive staff training, and strategic visual reminders throughout the unit. Cycle 2 (November 2023-January 2024) tested whether these changes could continue in 25 similar patients. We tracked Abbreviated Mental Test Score (AMTS) documentation at four critical junctures: admission, postoperative days 1 and 2, and the day 4 orthogeriatric review. Results: The change occurred in a noticeable way, but it was not brought to completion. Initial AMTS documentation improved from 14 (46.7%) to 18 (72%) between cycles. Most dramatically, postoperative day 1 assessments, completely absent at baseline, reached nine (36%) completions, while day 2 assessments climbed from zero to four (16%). However, orthogeriatric day 4 assessments actually declined from 19 (63.3%) to 13 (52%), suggesting intervention fatigue. The shift to electronic records proved double-edged-boosting admission assessments while paradoxically disrupting established day 4 documentation routines. Conclusions: Strategic interventions can revolutionize cognitive assessment practices, particularly for initial screening, but sustaining these gains demands more than one-time fixes. While education and visual cues successfully embedded new behaviors, the persistent gaps in postoperative reassessment reveal the challenge of truly transforming clinical culture. Success requires not just implementing change but hardwiring it through workflow integration, electronic health record (EHR) optimization, and relentless performance monitoring.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.