Date of Award

Fall 2015

Project Type


College or School




Program or Major


Degree Name

Master of Science

First Advisor

Pamela P. DiNapoli


Background: As the incidence of cognitive impairment continues to rise, timely and accuratediagnoses are essential. Aim: The aim of this quality improvement project was to evaluate the standard cognitiveassessment screening for Bhutanese refugees in a medical home, and compare an alternative,validated, and potentially more culturally appropriate tool. Also, an assessment of provider,nurse and interpreter satisfaction with the two tools was performed. Method: Mixed methods including qualitative observations and quantitative satisfaction surveysrelated to the implementation of a culturally appropriate cognitive assessment tool. Results: When assessed with the standard tool, all 10 people screened positive for cognitiveimpairment. However, when using the alternative tool on the same sample, 4 of the 7 peoplescreened positive, but with less impairment. Accounting for this difference was language,literacy and a different alphabet. Results of the pre-and-post surveys indicated an increase inprovider, nurse and interpreter satisfaction with the alternative cognitive assessment screeningtool with Bhutanese refugees. Conclusion and Implications for CNL Practice: Providing culturally appropriate screeningtools in diverse populations potentially decreases the chance of misdiagnosis and under-diagnosis. The validated alternative tool has the potential of providing more accurate andtimelier diagnoses, resulting in a higher level of patient and family-centered care andsatisfaction. Limitations and Clinical Nurse Leader implications will be discussed.

Included in

Nursing Commons