Citation

Warnier RM, van Rossum E, van Kuijk SM, Magdelijns F, Schols JM, Kempen GI. J. Clin. Nurs. 2019; ePub(ePub): ePub.

Affiliation

Care and Public Health Research Institute (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/jocn.15148

PMID

31856316

Abstract

AIMS AND OBJECTIVES: The objective of the study is to examine the predictive properties of the brief Dutch National Safety Management Program for the screening of frail hospitalized older patients (VMS) and to compare these with the more extensive Maastricht Frailty Screening Tool for Hospitalized Patients (MFST-HP).

BACKGROUND: Screening of older patients during admission may help to detect frailty and underlying geriatric conditions. The VMS screening assesses patients on 4 domains (i.e. functional decline, delirium risk, fall risk, nutrition). The 15-item MFST-HP assesses patients on 3 domains of frailty (physical, social and psychological).

DESIGN: Retrospective cohort study.

METHODS: Data of 2,573 hospitalized patients (70+) admitted in 2013 were included and relative risks, sensitivity and specificity and area under the receiver operating curve (AUC) of the two tools were calculated for discharge destination, readmissions and mortality. The data were derived from the patients nursing files. A STARD checklist was completed.

RESULTS: Different proportions of frail patients were identified by means of both tools: 1,369 (53.2%) based on the VMS and 414 (16.1%) based on the MFST-HP. The specificity was low for the VMS and the sensitivity was low for the MFST-HP. The overall AUC for the VMS varied from 0.50 to 0.76 and from 0.49 to 0.69 for the MFST-HP.

CONCLUSION: The predictive properties of the VMS and the more extended MFST-HP on the screening of frailty among older hospitalized patients are poor to moderate and not very promising. RELEVANCE TO CLINICAL PRACTICE: The VMS labels a high proportion of older patients as potentially frail while the MFST-HP labels over 80% as non-frail. An extended tool did not increase the predictive ability of the VMS. However, information derived from the individual items of the screening tools may help nurses in daily practice to intervene on potential geriatric risks such as delirium risk or fall risk.

© 2019 John Wiley & Sons Ltd.

Language: en

Keywords

Frailty screening; Geriatric assessment; Hospitalized Patients; Nursing assessment; Risk screening; Safety program; feasibility; frailty; validity