Abstract
BackgroundRoutine screening for frailty at admission by nurses may be useful to detect geriatric risks and problems at an early stage. However, the added value of this screening is not clear yet. Information about the opinions and attitudes of nurses towards this screening is also lacking. As they have a crucial role in conducting this screening, an exploratory study was performed to examine hospital nurses’ opinions and perspectives about this screening and how it influences their daily work.MethodsA qualitative, exploratory approach was employed, using semi-structured interviews with 13 nurses working on different general medical wards (surgical and internal medicine) in three Dutch hospitals. Frailty screening had been implemented for several years in these hospitals.ResultsThe participating nurses reported that frailty screening can be useful to structure their work, create more awareness of frail older patients and as starting point for pro-active nursing care. At the same time, they assess their clinical view as more important than the results of a standard screening tool. The nurses hardly used the overall screening scores, but were particularly interested in information regarding specific items, such as delirium or fall risk. Screening results are partly embedded systematically and in daily nursing care, e.g., in team briefings or during transfer of patients to other wards. The majority of the nurses had received little training about the background of frailty screening and the use of screening tools.ConclusionsMost nurses stated that frailty screening tools are helpful in daily practice. However, nurses did not use the frailty screening tools in the referred way; tools were particularly used to evaluate patients on separate items of the tool instead of the summative score of the tool. When frailty screening tools are implemented in daily practice, training needs to be focused on. Additional research in this field is necessary to gain more insight into nurses’ opinions on frailty screening.
Highlights
Routine screening for frailty at admission by nurses may be useful to detect geriatric risks and problems at an early stage
Initial screening by nurses during admission for frailty had been implemented for several years and older patients were admitted to almost all wards throughout the hospital
The screening consists of four domains: delirium risk, fall risk, malnutrition and risk of functional decline [20]
Summary
Routine screening for frailty at admission by nurses may be useful to detect geriatric risks and problems at an early stage. Acute care hospitals are becoming more and more geriatric services, approximately one third of the Warnier et al BMC Geriatr (2021) 21:624 admitted patients is 70 years and over [2] This affects the work of the nursing staff are responsible for the care of these older patients at all times [3]. Acute hospital admissions are not without risks for older patients They are associated with an increased risk of negative health outcomes such as iatrogenic complications, delirium, and functional decline [4,5,6]. Functional decline and frailty contribute to negative short and long-term health outcomes [10], such as a prolonged hospital stay [11], frequent readmission to hospital, admission to a nursing home, and increased mortality [12, 13]. Length of hospital stay was higher for frail older adults (13.5 days) compared with nonfrail (8.3 days) [14, 15]
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