An integrative review on screening for frailty in acute care: Accuracy, barriers to implementation and adoption strategies

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HighlightsFrailty in elderly leads to functional decline and increased health care utilisation cost.Effective screening identifies frail adults for timely interventions and reduces frailty effect.Lack of established tools which are valid and reliable for use in acute care settings.Validity and reliability of current frailty tools need to be improved.Main barriers need to be addressed to facilitate early frailty screening.Frailty is a multifactorial clinical syndrome associated with increased vulnerability to negative health-related outcomes including disease and disability. Many frailty screening tools are established for use in community settings with few for acute care. An integrative review methodology by Whittemore and Knafl, was adopted to summarise the reliability and validity of different frailty screening tools, barriers to implementation and adoption strategies in acute care settings. Thirteen relevant papers met the inclusion criteria. Validity and reliability of 14 screening tools were reported in 10 studies, whereas barriers identified in implementing frailty screening and potential adoption strategies were reported in 5 studies. Accuracy of screening tools require further improvement before use in hospitalized elderly. Strategies including the improvement of hospital guidelines and practices, promoting early involvement of stakeholders, and choosing a reliable and quick to administer screening tool can be implemented to help improve and facilitate early frailty screening in acute care.

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