Literature DB >> 16641142

Nurse-led implementation of the single assessment process in primary care: a descriptive feasibility study.

Helen C Roberts1, Zoe M Hemsley, Gwen Thomas, Philip Meakins, Jackie Powell, Judy Robison, Ian Gove, Gill Turner, Avan Aihie Sayer.   

Abstract

OBJECTIVE: to determine the resources required to carry out the single assessment process in primary care.
DESIGN: prospective descriptive study.
SETTING: one urban primary care practice, Southampton. PARTICIPANTS: nine hundred and forty-four people aged 70+ years, registered with the practice, not living in a residential/nursing home, or terminally ill. INTERVENTION: participants were sent the six-item Sherbrooke questionnaire (case-finding tool). Non-responders were re-mailed after 4 weeks. All those scoring 4, 5 or 6 and a randomly selected half of those scoring 2 or 3 were offered overview assessment and comprehensive assessment as indicated by the Minimum Data Set for Home Care protocol. The nurse assessor identified unmet needs and agreed an action plan with participants. Another researcher conducted semi-structured interviews with a purposive sample of 26 participants to elicit their views of the process. MAIN OUTCOME MEASURES: response rates/scores of Sherbrooke questionnaire; numbers/characteristics of people requiring overview and comprehensive assessments; nature of resulting recommendations/referrals and impact on other agencies; resources required; views of service users.
RESULTS: eight hundred and sixty-three (91%) participants replied. Five hundred and seven (54%) scored 2+, triggering an overview assessment, which was offered to 307. One hundred and twenty-four participants (40%) accepted; 64 (52%) had unmet needs (median 8 each, range 2-18), resulting in 34 referrals within the practice including four case conferences, and 21 to community/secondary health services. Few participants with a Sherbrooke score of 2 required comprehensive assessment. Users perceived the process as acceptable and useful, but not always relevant to their current needs.
CONCLUSION: targeting those scoring 3+ on the Sherbrooke questionnaire (28% of sample) may improve the identification of patients who would benefit from further assessment. A contact approach rather than a case-finding one may improve the relevance of this process to older people.

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Year:  2006        PMID: 16641142     DOI: 10.1093/ageing/afl008

Source DB:  PubMed          Journal:  Age Ageing        ISSN: 0002-0729            Impact factor:   10.668


  4 in total

1.  The psychometric properties of three self-report screening instruments for identifying frail older people in the community.

Authors:  Silke F Metzelthin; Ramon Daniëls; Erik van Rossum; Luc de Witte; Wim J A van den Heuvel; Gertrudis I J M Kempen
Journal:  BMC Public Health       Date:  2010-03-31       Impact factor: 3.295

2.  The predictive validity of three self-report screening instruments for identifying frail older people in the community.

Authors:  Ramon Daniels; Erik van Rossum; Anna Beurskens; Wim van den Heuvel; Luc de Witte
Journal:  BMC Public Health       Date:  2012-01-23       Impact factor: 3.295

3.  Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

Authors:  Rónán O'Caoimh; Yang Gao; Anton Svendrovski; Elizabeth Healy; Elizabeth O'Connell; Gabrielle O'Keeffe; Una Cronin; Eileen O'Herlihy; Nicola Cornally; William D Molloy
Journal:  BMC Geriatr       Date:  2014-09-19       Impact factor: 3.921

4.  The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults.

Authors:  Rónán O'Caoimh; Yang Gao; Anton Svendrovski; Elizabeth Healy; Elizabeth O'Connell; Gabrielle O'Keeffe; Una Cronin; Estera Igras; Eileen O'Herlihy; Carol Fitzgerald; Elizabeth Weathers; Patricia Leahy-Warren; Nicola Cornally; D William Molloy
Journal:  BMC Geriatr       Date:  2015-07-30       Impact factor: 3.921

  4 in total

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