Effects Of Education and Increased Availability of Standardized Frailty Screen on Implementation of Frailty Screening and Risk Reduction Interventions In Certified Registered Nurse Anesthetists

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)

Travis Bridges (Creator)

Institution

The University of North Carolina at Greensboro (UNCG )

Web Site: http://library.uncg.edu/

Advisor

Joshua Borders

Abstract: Background: Despite a growing body of evidence supporting the use of frailty as an extremely sensitive predictor of perioperative morbidity and mortality, the adoption of standardized frailty assessments in anesthesia has been very limited. Postoperative cognitive dysfunction and delirium are strongly associated with frailty and represent a significant adverse reaction related to the physiologic stresses of anesthesia and surgery. These disorders can have significant long-term effects and may be a catalyst for permanent physical deterioration. High perioperative production pressure and the prevalence of inaccurate, subjective estimations of frailty contribute to the scarce unitization of objective frailty screening. Purpose: Develop an educational module and reference material to improve the implementation of preoperative frailty screening and risk reduction interventions by CRNAs.Methods: Our study utilized a quasi-experimental, pretest-posttest study design and was conducted at Duke Raleigh Hospital. We delivered an informative presentation addressing the efficacy of frailty screening, the strong association with perioperative mortality, and suggested risk-reduction interventions. In addition, we disseminated a quick reference guide that outlines the steps for conducting a 'FRAIL' scale assessment, a well-validated tool for assessing frailty in older adults."" Pretest-posttest surveys, containing a mix of Likert style and multiple-choice questions were collected digitally prior to and 30 days after our intervention. Results: During our study period, we had 17 CRNAs respond to the pre-test and 9 CRNAs respond to our post-test. Respondents endorsed an increased utilization of a standardized method of assessing frailty (6% vs 25%) and increased implementation of risk-reduction interventions (43.6% vs 56.3%), though our analysis failed to find statistical significance. Recommendations and Conclusion: Although a standardized method of frailty screening has shown to be an incredibly valuable tool for estimating perioperative risk, subjective/anecdotal estimation of patient frailty remains the prevailing means of preoperative assessment. More research is needed to determine the most effective means for incorporating frailty assessment into anesthesia practice, as adding an additional non-clinical/administrative task remains a significant roadblock.

Effects Of Education and Increased Availability of Standardized Frailty Screen on Implementation of Frailty Screening and Risk Reduction Interventions In Certified Registered Nurse Anesthetists
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Created on 6/20/2024
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Additional Information

Publication

Other

Language: English

Date: 2023

Keywords

frailty assessment, anesthesia, badge buddy, delirium

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