Care and Public Health Research Institute (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
Envida, Care for Elderly, Department of Treatment and Guidance, Vijverdalseweg 10, 6226, NB, Maastricht, The Netherlands.
BMC Geriatr. 2021 Nov 3;21(1):624. doi: 10.1186/s12877-021-02586-z.
Routine 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.
A 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.
The 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.
Most 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.
护士在入院时对虚弱进行常规筛查，可能有助于早期发现老年病风险和问题。然而，这种筛查的附加价值尚不清楚。关于护士对这种筛查的意见和态度的信息也缺乏。由于他们在进行这种筛查方面起着至关重要的作用，因此进行了一项探索性研究，以检查医院护士对这种筛查的意见和看法，以及这种筛查如何影响他们的日常工作。
采用定性、探索性方法，对在荷兰三家医院的不同普通内科病房（外科和内科）工作的 13 名护士进行半结构化访谈。这些医院已经实施了多年的虚弱筛查。
参与研究的护士报告称，虚弱筛查可以帮助他们组织工作，提高对虚弱老年患者的认识，并作为主动护理的起点。与此同时，他们认为自己的临床观点比标准筛查工具的结果更重要。护士几乎不使用整体筛查评分，但对特定项目的信息特别感兴趣，例如谵妄或跌倒风险。筛查结果部分系统地嵌入日常护理中，例如在团队简报或患者转科时。大多数护士几乎没有接受过有关虚弱筛查背景和筛查工具使用的培训。
大多数护士表示，虚弱筛查工具在日常实践中是有帮助的。然而，护士并没有按照规定的方式使用虚弱筛查工具；工具主要用于评估患者在工具的个别项目上的情况，而不是工具的综合评分。当在日常实践中实施虚弱筛查工具时，需要进行培训。在这一领域需要进行更多的研究，以进一步了解护士对虚弱筛查的看法。
