Surgical frailty assessment: a missed opportunity
Abstract Background Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals’ use of frailty assessment for perioperative care. Methods Healthcare pr...
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doaj-391095414a2946a58c476bbd8ac1119a2020-11-25T03:40:27ZengBMCBMC Anesthesiology1471-22532017-07-011711810.1186/s12871-017-0390-7Surgical frailty assessment: a missed opportunityGilgamesh Eamer0Jennifer A. Gibson1Chelsia Gillis2Amy T. Hsu3Marian Krawczyk4Emily MacDonald5Reid Whitlock6Rachel G. Khadaroo7Department of Surgery, 2D, Walter C Mackenzie Health Sciences Centre, University of AlbertaSchool of Nursing, University of British ColumbiaCumming School of Medicine, University of CalgaryClinical Epidemiology Program, Ottawa Hospital Research InstituteCentre for Health Evaluation and Outcome Sciences, St. Paul HospitalDepartment of Nursing and Health Sciences, University of New BrunswickDepartment of Community Health Sciences, University of ManitobaDepartment of Surgery, 2D, Walter C Mackenzie Health Sciences Centre, University of AlbertaAbstract Background Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals’ use of frailty assessment for perioperative care. Methods Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients. The survey contained open-ended and 5-point Likert scale questions. Responses were compared across professions using independent sample t-tests and correlations between survey items were analyzed. Results Nurses and allied health professionals were more likely than surgeons to think frailty should play a role in planning a patient’s care (nurses vs. surgeons p = 0.008, allied health vs. surgeons p = 0.014). Very few respondents (17.5%) reported that they ‘always used’ a frailty assessment tool. Results from qualitative data analysis identified four main barriers to frailty assessment: institutional, healthcare system, professional knowledge, and patient/family barriers. Conclusion Across all disciplines, the lack of knowledge about frailty issues was a prominent barrier to the use of frailty assessments in practice, despite clinicians’ understanding that frailty affects their patients’ outcomes. Confidence in frailty assessment tool use through education and addressing barriers to implementation may increase use and improve patient care. Healthcare professionals agree that frailty assessments should play a role in perioperative care. However, few perform them in practice. Lack of knowledge about frailty is a key barrier in the use of frailty assessments and the majority of respondents agreed that they would benefit from further training.http://link.springer.com/article/10.1186/s12871-017-0390-7FrailtyOperative screeningImproving careSurveySurgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gilgamesh Eamer Jennifer A. Gibson Chelsia Gillis Amy T. Hsu Marian Krawczyk Emily MacDonald Reid Whitlock Rachel G. Khadaroo |
spellingShingle |
Gilgamesh Eamer Jennifer A. Gibson Chelsia Gillis Amy T. Hsu Marian Krawczyk Emily MacDonald Reid Whitlock Rachel G. Khadaroo Surgical frailty assessment: a missed opportunity BMC Anesthesiology Frailty Operative screening Improving care Survey Surgery |
author_facet |
Gilgamesh Eamer Jennifer A. Gibson Chelsia Gillis Amy T. Hsu Marian Krawczyk Emily MacDonald Reid Whitlock Rachel G. Khadaroo |
author_sort |
Gilgamesh Eamer |
title |
Surgical frailty assessment: a missed opportunity |
title_short |
Surgical frailty assessment: a missed opportunity |
title_full |
Surgical frailty assessment: a missed opportunity |
title_fullStr |
Surgical frailty assessment: a missed opportunity |
title_full_unstemmed |
Surgical frailty assessment: a missed opportunity |
title_sort |
surgical frailty assessment: a missed opportunity |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2017-07-01 |
description |
Abstract Background Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals’ use of frailty assessment for perioperative care. Methods Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients. The survey contained open-ended and 5-point Likert scale questions. Responses were compared across professions using independent sample t-tests and correlations between survey items were analyzed. Results Nurses and allied health professionals were more likely than surgeons to think frailty should play a role in planning a patient’s care (nurses vs. surgeons p = 0.008, allied health vs. surgeons p = 0.014). Very few respondents (17.5%) reported that they ‘always used’ a frailty assessment tool. Results from qualitative data analysis identified four main barriers to frailty assessment: institutional, healthcare system, professional knowledge, and patient/family barriers. Conclusion Across all disciplines, the lack of knowledge about frailty issues was a prominent barrier to the use of frailty assessments in practice, despite clinicians’ understanding that frailty affects their patients’ outcomes. Confidence in frailty assessment tool use through education and addressing barriers to implementation may increase use and improve patient care. Healthcare professionals agree that frailty assessments should play a role in perioperative care. However, few perform them in practice. Lack of knowledge about frailty is a key barrier in the use of frailty assessments and the majority of respondents agreed that they would benefit from further training. |
topic |
Frailty Operative screening Improving care Survey Surgery |
url |
http://link.springer.com/article/10.1186/s12871-017-0390-7 |
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