Beverley Clare

Advanced Clinical Practitioner and Occupational Therapist within North Manchester Community Crisis Response/urgent care service.

[Alasdair MacLullich @A_MacLullich]

The 4AT delirium assessment tool is already established as a well-validated & clinically effective method of delirium detection in practice.

It is scored 0-12. Scores of 4+ indicate delirium; scores of 1-3 indicate cognitive impairment.

A recent study found that scores of 1+ are strongly linked with known dementia Dx. This opens up the possibility that the 4AT can serve a dual purpose as both a delirium assessment tool AND a tool that could help identify dementia.

In the UK the Triple Assessment is mandated for all >65 emergency hospital admissions. This is: vital signs (NEWS2) / Clinical Frailty Score / 4AT.

🌠 These new findings suggest that the 4AT could also assist in other healthcare systems, e.g. the 4Ms framework used in the USA. In one short (2 min) tool it could help address the delirium & dementia elements of the Mentation element of the 4Ms.

🔗 to editorial & other sources below 👇

#delirium #dementia #medtwitter

[Beverley Clare @bevmcr]

@GaryGPN @A06Fehmid51039 @kcisc 100% agree. I’ve been a qualified ACP for the past 6 years and wouldn’t dream of coming out with shit the commenter in the images has. We are not Drs and never will be…ever (unless we train and obtain a medical degree)!

[Alasdair MacLullich @A_MacLullich]

Infographic on #delirium prevention and management from the American College of Chest Physicians

[Alasdair MacLullich @A_MacLullich]

5 tips for communicating with older adults with #delirium - from the Regional Geriatric Program of Toronto.

[Beverley Clare @bevmcr]

@Caesarnots96696 @9nzmwjkxmyP @DocDoLi Patient safety is a priority and should be for everyone working in the NHS. Yes I’ve known a couple of over confident ACPs but they don’t fair very well in our team because we’ll call em out and they end up leaving. ACPs are not Drs and we should not be used as such!

[Beverley Clare @bevmcr]

@9nzmwjkxmyP @DocDoLi Wow! That is utterly terrifying. To be clear ACPs and PAs CANNOT do their job in supporting Drs without the Drs supporting us to do ours. We need our fully fledged Drs, the govt’s idea that we don’t is ridiculous as it is terrifying.

[Beverley Clare @bevmcr]

@DocDoLi @9nzmwjkxmyP We (our team) don’t just go around doing what we like is what I’m trying to say..

[Beverley Clare @bevmcr]

@DocDoLi @9nzmwjkxmyP I’m not a nurse! I’m an OT by background, I’ve worked for 18 years in frailty,urgent care, palliative care, acute med. I did all my training in acute med. we share the governance with GP and secondary care to come up with a plan for the pt. The governance is VERY strict!

[Beverley Clare @bevmcr]

@9nzmwjkxmyP @DocDoLi It’s unbelievably disgusting that Drs are out of work and I’m genuinely sorry that’s happening. But let’s be honest, that’s not the fault of ACPs who have unskilled, that’s the fault of the gov’t who are pushing for a 2 tiered system.

[Beverley Clare @bevmcr]

@9nzmwjkxmyP @DocDoLi We don’t do the work of Drs though? Any ACP thinking they do is a concern. We can support you and take some pressure off (GPs n my case) but I don’t know any ACP who considers themself on a par with you and if they do they need taking to task.

[Beverley Clare @bevmcr]

@guidelinexpert @DocDoLi Are they? What all of them? I’ve never been told that, neither have my colleagues and none of us think that. In terms of equivalence there’s no such thing in my opinion. You’re either a qualified Dr or you’re not.

[Beverley Clare @bevmcr]

@ClinOncDoc @mancunianmedic As Drs..

[Beverley Clare @bevmcr]

@sisnshsnshs @ItsnotrightUK Care homes

[Beverley Clare @bevmcr]

@jobbinggasman @ItsnotrightUK Care homes..

[Beverley Clare @bevmcr]

@tomkoczian Agreed! I’m an Advanced Clinical Practitioner who happens to be an OT and while I feel there is a role for OTs/PTs/Paramedics etc in primary care, it should never ever include undiagnosed/undifferentiated pts. Whats needed are more GPs!

[Beverley Clare @bevmcr]

@CathMcCoy @DeniseC48200342 @JackieHammerton @suzypuss @EmergMedDr @PayalWilson @53brantingham Yes, as do I after eventually seeing the original post. I’ve apologised for reacting as I did, the origins of the thread didn’t show in my feed and it just looked like Den was being rude about OTs only being able to raise toilet seats.

[Beverley Clare @bevmcr]

@DeniseC48200342 @JackieHammerton @suzypuss @EmergMedDr @PayalWilson @53brantingham @CathMcCoy Actually, I apologise I didn’t see the post you were originally responding too. I agree OTs shouldn’t be seeing undifferentiated patients.

[Beverley Clare @bevmcr]

@DeniseC48200342 @JackieHammerton @suzypuss @EmergMedDr @PayalWilson @53brantingham @CathMcCoy I get what you’re saying but maybe listen to Primary Care Knowledge boost..’Occupational Therapists in primary care’ .. https://t.co/1EuVtUONwA