Assessing an Educational Intervention to Improve Recognition of Frailty in Hospitalized Patients with COPD

Abstract

Title: Assessing an Educational Intervention to Improve Recognition of Frailty in Hospitalized Patients with COPD Background: Frailty is common among COPD patients and is associated with poor health outcomes. There is a lack of data regarding the reliability of frailty assessments by frontline hospital staff. Objectives: 1. Design an educational intervention to improve the recognition of frailty among acute-care nurses. 2. Evaluate the inter-rater reliability of frailty assessments among nurses compared to a gold standard (GS). Methods: We conducted a mixed-methods study with 27 Registered Nurses (RNs) on a respiratory hospital ward. RNs evaluated 10 clinical vignettes and assigned a frailty score to each using the validated Clinical Frailty Scale (1=well to 8=terminally ill). A 1-hour frailty educational intervention was delivered to RNs. 1-week later the RNs assigned ratings to the same 10 vignettes. Fleiss Kappa were used to determine agreement between RN and GS ratings for each case. Results: For all scored cases, kappa measurements increased post-education compared to pre-education or remained stable in the case of frailty rating 3. No RN was able to identify vignettes with a GS frailty rating of 8 (Table 1). Conclusion: A 1-hour frailty educational intervention improved RNs ability to provide reliable frailty ratings among patients with COPD. Frailty rating of 8 was difficult to recognize among RNs.