Comparison of Frailty Screening Tools in the Emergency Department
Evaluation was done to determine the most suitable frailty screening tool for the Emergency Department at Beaumont Hospital. The study compared the Clinical Frailty Score (CFS), THINK FRAIL, InterRAI, and PRISMA-7. Results showed that the CFS was the most consistent tool, leading to a transition towards using it exclusively. This change aimed to ensure effective frailty identification and tailored care in the Emergency Department setting.
- Frailty Screening Tools
- Emergency Department
- Clinical Frailty Score
- Frailty Management
- Beaumont Hospital
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
A COMPARISON OF THE CFS, THINK FRAIL, INTERRAI AND PRISMA 7 WITHIN THE EMERGENCY DEPARTMENT NAME: KARA MC LOUGHLIN, CAROL LYONS, LOUISE MCGETTIGAN, PAUL MALONEY DEPARTMENT: FRAILTY INTERVENTION THERAPY TEAM, EMERGENCY DEPARTMENT HOSPITAL: BEAUMONT HOSPITAL @FITTBEAUMONT
Aim Background To evaluate which frailty screening tool would best meet our needs to screen appropriate patients and highlight the current level of frailty within the Emergency Department. The presence of frailty continues to be a prominent feature within Emergency Departments both nationally and internationally. Increased awareness has been given to the value of identifying frail for risk stratification and to assist in providing frailty attuned care rather than disease specific input. The need for expertise in frailty management within the ED has been highlighted at an international level and within Beaumont Emergency Department this has been provided in the form of FITT. Change initiative Over a 3 day period all patients over 75 who present during core hours were screened by a senior FITT member using a number of frailty tools (CFS, THINK frail, InterRai, PRIMSA 7 & compared against our own clinical reasoning if a FITT assessment was indicated). The team currently use the THINK FRAIL & the Clinical Frailty Score (CFS) screening tools however due to change in research we wanted to review if this is still an appropriate tool to use The CFS & THINK frail tools are already utilised by FITT therefore the FITT score were also compared to the screeners score.
50 Results CFS 44 THINK FRAIL Same 40 70 36 58.33 Total Patient s over 75 screened by screener & 60 1 point diff 30 50 CFS same 40 20 31.25 20 1 point diff 30 FITT 48 > 1 point 20 10.42 10 10 Average age: 82 0 0 CFS same 1 point diff > 1 point Same 1 point diff > 1 point Sex: 51.62% male Average CFS (Screener) = 5 Average THINK Frail (Screener): 3 Discharges: 57% d/c'd Average CFS (FITT) = 5 Average THINK Frail (FITT): 2 28/48 CFS same = 58.33% 17/47 THINK Frail same =36% 15/48 CFS differ by 1 point = 31.25% 21/47 THINK Frail differ by 1 point = 44% 89.58% same or within 1 point difference 80.85 % same or within 1 point difference Key Outcomes From a review of our current practice there were a number of variations noted in the use of our current screening tool-THINK FRAIL, when comparing results. The CFS score was the most consistent when comparing scores by multiple disciplines/grades. Although the majority of older adults who scored a CFS of 1-3 or deemed non frail at triage were unlikely to benefit from a CGA , those who presented with a new fall often did require FITT input. This research has led us to move away from our current triage tool of THINK FRAIL to the CFS , whilst continuing to assess any new falls irrespective of score.
Sustained- how was the improvement sustained Following this work our team have now moved to use the CFS only as our frailty screening tool We have also provided education throughout the ED department on its use and have commenced a department wide initiative to introduce its use Value to patients Spread/Additional Information We have now moved to an internationally recognised frailty tool which best identifies frailty in our Emergency Department & allows us to adapt our approach accordingly The CFS has now being introduced to our ED triage for all adults over 65. This is the first ED in the country to successful do this on a 24/7 basis
