Abstract
AimTo identify and establish expert consensus on important and feasible components of a nurse‐led, comprehensive geriatric assessment (CGA)‐based intervention for community‐dwelling older people who live with frailty.DesignA three‐round modified e‐Delphi survey.MethodsAn expert panel of 33 UK specialist older people's, primary and community care nurses participated in the three‐round e‐Delphi survey over a 12‐month period in 2017–2018. Data from round 1 were analysed using content analysis. Descriptive statistics were used in the subsequent two rounds to demonstrate convergence of panel opinion and consensus.ResultsIn round 1, experts proposed 30 CGA components that were combined with six additional components from a literature review and clustered into six domains. In round 2, components were rated for importance and feasibility. Rating scores for importance were high across all domains, with lower scores for feasibility. Round 3 revealed that 36 components achieved consensus on importance and 11 out of 36 components reached consensus on feasibility.ConclusionBased on expert panel opinion, the content of a nurse‐led CGA‐based intervention was established, with the aim of future feasibility testing in a randomized controlled trial.ImpactThis study provides feasible components of a CGA‐based intervention that can be implemented in clinical practice by nurses in partnership with older people who live with frailty. Following further testing and evaluation, the components have the potential to improve clinical outcomes, maximize independence and improve the quality of life for community‐dwelling frail older people.
Highlights
The population is ageing and, this is undoubtedly a success for improved public health and welfare leading to longer life expectancy, it brings with it the challenge of meeting the health and social care needs of higher numbers of older people
This formed the focus of this Delphi study, which is part of a larger programme of research related to the development and implementation of a nurse-led, comprehensive geriatric assessment (CGA)-based intervention
This study aimed to identify and obtain expert consensus on important and feasible components of a nurse-led, CGA-based intervention for community dwelling older people who live with frailty
Summary
The population is ageing and, this is undoubtedly a success for improved public health and welfare leading to longer life expectancy, it brings with it the challenge of meeting the health and social care needs of higher numbers of older people. Another review attempted to identify approaches to CGA in primary care and there were several in existence, the authors highlighted the need for more research into what is feasible for large numbers of the population (Morley et al, 2017) Professional organizations, such as the British Geriatrics Society (BGS), advocate for a multi-professional approach to supporting frail patients and point to evidence that nurses and allied health professionals can successfully lead and provide input into the assessment and care planning process (Schadewaldt et al, 2013). In addition to advanced clinical skills, several studies have highlighted the importance of a goal-orientated intervention focussing on person-centeredness and self-management This approach should be built on a caring, supportive relationship between the nurse and patient (Imhof et al, 2012). This formed the focus of this Delphi study, which is part of a larger programme of research related to the development and implementation of a nurse-led, CGA-based intervention
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