Many Tools Are Developed to Help Nurses Assess Their Patients

Assessment Tool Analysis

Many tools are developed to help nurses assess their patients. Some tools are designed to assess mental disorders. These tools give nurses the tools to assess and help the patient and physician to care for the patient. The Mini-Mental State Exam is a nonthreatening way for the nurse to assess for possible problems in cognition. The Beck Depression Inventory is a way for the nurse to assess for depression in adults. The Dysfunctional Attitude Scale is often used with adolescents to assess for self-defeating that could mean underlying depression or anxiety. Assessing cognition, depression and anxiety in patients is required if the nurse is to treat the patient holistically.

The Mini-Mental State Exam was developed for health care professionals to assess for possible problems with cognition such as dementia. For years, the need for a short exam to assess cognition was needed. The Mini-Mental State Exam or MMSE was developed by Folstein, Fostein, and McHugh in 1975. This tool was mainly developed for the elderly, but it can be used for adults too. The MMSE has 11 questions with a maximum score of 30. The lower the score the more cognitively impaired. For scores of zero to 17 suggest severe cognitive impairment, 18-23 suggests mild impairment and scores 24-30 suggest lack of deficit (Chiriboga, McHugh, & Sweeney, 2004). It takes about 10 minutes to complete the exam, which includes arithmetic, memory, and orientation. The test is accurate if used correctly. Often assessors will alter the questions to adapt them to the patient.

Cognitive impairment is no longer considered normal as people age. The Mini-Mental State Exam helps the nurse assess a patient’s cognitive ability. By having a guide to determine level of impairment, the nurse can develop a comprehensive care plan based on the patient’s individual needs surrounding cognitive status. Patients with severe hearing loss may be thought of having some cognitive impairment based on their response to questions when they do not understand the question because of the hearing loss. To administer the MMSE effectively, the assessor needs to evaluate if the patient has adequate hearing. If not, the assessor needs to speak up or find the patient an amplified hearing device.

The Beck Depression Inventory is questions asked to those with a psychiatric diagnosis to establish severity of depression. The form is fairly long, composed of 21 questions, each with four possible answers. Questions 1-13 geared toward psychological issues whereas questions 14-21 are geared toward physical characteristics. The BDI was developed in 1961 by Aaron T. Beck and copyrighted in 1979. Scores of zero to nine indicates minimal depressive symptoms, 10-16 indicates mild depression, 17-29 indicates moderate depression, and scores 30-63 indicates severe depression. A shorter seven-question form was developed for primary