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Risk Screening Tool (risk + screening_tool)
Selected AbstractsThe Identification of Seniors At Risk Screening Tool: Further Evidence of Concurrent and Predictive ValidityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Nandini Dendukuri PhD Objectives: To evaluate the validity of the Identification of Seniors at Risk (ISAR) screening tool for detecting severe functional impairment and depression and predicting increased depressive symptoms and increased utilization of health services. Setting: Four university-affiliated hospitals in Montreal. Design: Data from two previous studies were available: Study 1, in which the ISAR scale was developed (n=1,122), and Study 2, in which it was used to identify patients for a randomized trial of a nursing intervention (n=1,889 with administrative data, of which 520 also had clinical data). Participants: Patients aged 65 and older who were to be released from an emergency department (ED). Measurements: Baseline validation criteria included premorbid functional status in both studies and depression in Study 2 only. Increase in depressive symptoms at 4-month follow-up was assessed in Study 2. Information on health services utilization during the 5 months after the ED visit (repeat ED visits and hospitalization in both studies, visits to community health centers in Study 2) was available by linkage with administrative databases. Results: Estimates of the area under the receiver operating characteristic curve (AUC) for concurrent validity of the ISAR scale for severe functional impairment and depression ranged from 0.65 to 0.86. Estimates of the AUC for predictive validity for increased depressive symptoms and high utilization of health services ranged from 0.61 to 0.71. Conclusion: The ISAR scale has acceptable to excellent concurrent and predictive validity for a variety of outcomes, including clinical measures and utilization of health services. [source] Nurse discharge planning in the emergency department: a Toowoomba, Australia, studyJOURNAL OF CLINICAL NURSING, Issue 8 2006Desley Hegney BA Aim., This study aimed to ascertain whether a model of risk screening carried out by an experienced community nurse was effective in decreasing re-presentations and readmissions and the length of stay of older people presenting to an Australian emergency department. Objectives., The objectives of the study were to (i) identify all older people who presented to the emergency department of an Australian regional hospital; (ii) identify the proportion of re-presentations and readmissions within this cohort of patients; and (iii) risk-screen all older patients and provide referrals when necessary to community services. Design., The study involved the application of a risk screening tool to 2139 men and women over 70 years of age from October 2002 to June 2003. Of these, 1102 (51·5%) were admitted and 246 (11·5%) were re-presentations with the same illness. Patients presenting from Monday to Friday from 08:00 to 16:00 hours were risk-screened face to face in the emergency department. Outside of these hours, but within 72 hours of presentation, risk screening was carried out by telephone if the patient was discharged or within the ward if the patient had been admitted. Results., There was a 16% decrease in the re-presentation rate of people over 70 years of age to the emergency department. Additionally during this time there was a 5·5% decrease in the readmission rate (this decrease did not reach significance). There was a decrease in the average length of stay in hospital from 6·17 days per patient in October 2002 to 5·37 days per patient in June 2003. An unexpected finding was the decrease in re-presentations in people who represented to the emergency department three or more times per month (known as ,frequent flyers'). Conclusions., Risk screening of older people in the emergency department by a specialist community nurse resulted in a decrease of re-presentations to the emergency department. There was some evidence of a decreased length of stay. It is suggested that the decrease in re-presentations was the result of increased referral and use of community services. It appears that the use of a specialist community nurse to undertake risk screening rather than the triage nurse may impact on service utilization. Relevance to clinical practice., It is apparent that older people presenting to the emergency department have complex care needs. Undertaking risk screening using an experienced community nurse to ascertain the correct level of community assistance required and ensuring speedy referral to appropriate community services has positive outcomes for both the hospital and the patient. [source] Four-item fall risk screening tool for subacute and residential aged care: The first step in fall preventionAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2009Caroline Stapleton Aim:, To report the reliability, accuracy and compliance of a brief fall risk screening tool in subacute and residential aged care. Method:, A 9-item tool, developed by expert and literature review, was administered to 291 persons admitted to subacute and residential aged care at Peninsula Health (PH) Victoria, Australia. Items were analysed for their ability to predict falls and the four strongest incorporated into a screening tool. Reliability was assessed on six nurses. Results:, Most predictive items were recent falls (0.82), psychological status (0.55), medications (0.46) and cognition (0.41) ,2 (4, n= 291) = 89.89, P < 0.0001. The final 4-item tool (PH-FRAT) provides 80% accuracy (sensitivityER 70.2%, specificityER 68.8%) and high reliability (ICC = 0.79). The PH-FRAT is now used in 50 local subacute and residential facilities. Conclusion:, The 4-item PH-FRAT is a popular, moderately predictive, reliable and brief method of screening fall risk in subacute and residential aged care. [source] | ||||||||||