PO016 Audit of neurological examinations in acute admissions

Background It is noticed clinically that for acute inpatient admissions, neurological examinations are often incomplete or omitted in initial assessment. Hence we audited how often neurological examinations are performed on admission. Thereafter we propose the Glasgow Neuroscreen – a quick neurological screening examination especially in patients with non-neurological presenting complaints to exclude important neurological signs and improve examination rates. The efficacy of the Glasgow Neuroscreen will be evaluated. Methods Consented patients’ clerk-in notes were audited to evaluate how often various components of the neurological examination were performed. Glasgow Neuroscreen was tested on these patients using either of 2 algorithms- ambulant/non ambulant patients. The normal examination findings were used as standard for comparison against Neuroscreen findings to evaluate its reliability. Results Of 30 patients, 17 (56.67%) had some documentation of neurological examination. Only 48% of patients with non-neurological presenting complaints were examined neurologically. Analysis of Neuroscreen showed a sensitivity of 80% and specificity of 33.3%. The positive predictive value stands at 33.3% whereas the negative predictive value is 80%. Discussion For general or non- neurological presenting complaints, neurological examinations are often omitted possibly due to time constraints hence the Neuroscreen could be useful as a quick screening tool in these patients.