• Ron M J Warnier, Erik van Rossum, van KuijkSander M JSMJClinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands., Fabienne Magdelijns, ScholsJos M G AJMGADepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht, and KempenGertrudis I J MGIJMDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands..
• Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
• J Clin Nurs. 2020 Apr 1; 29 (7-8): 1064-1073.

Aims And ObjectivesTo examine the predictive properties of the brief Dutch National Safety Management Program for the screening of frail hospitalised older patients (VMS) and to compare these with the more extensive Maastricht Frailty Screening Tool for Hospitalised Patients (MFST-HP).BackgroundScreening of older patients during admission may help to detect frailty and underlying geriatric conditions. The VMS screening assesses patients on four domains (i.e. functional decline, delirium risk, fall risk and nutrition). The 15-item MFST-HP assesses patients on three domains of frailty (physical, social and psychological).DesignRetrospective cohort study.MethodsData of 2,573 hospitalised patients (70+) admitted in 2013 were included, and relative risks, sensitivity and specificity and area under the receiver operating characteristic (AUC) curve of the two tools were calculated for discharge destination, readmissions and mortality. The data were derived from the patients nursing files. A STARD checklist was completed.ResultsDifferent proportions of frail patients were identified by means of both tools: 1,369 (53.2%) based on the VMS and 414 (16.1%) based on the MFST-HP. The specificity was low for the VMS, and the sensitivity was low for the MFST-HP. The overall AUC for the VMS varied from 0.50 to 0.76 and from 0.49 to 0.69 for the MFST-HP.ConclusionThe predictive properties of the VMS and the more extended MFST-HP on the screening of frailty among older hospitalised patients are poor to moderate and not very promising.Relevance To Clinical PracticeThe VMS labels a high proportion of older patients as potentially frail, while the MFST-HP labels over 80% as nonfrail. An extended tool did not increase the predictive ability of the VMS. However, information derived from the individual items of the screening tools may help nurses in daily practice to intervene on potential geriatric risks such as delirium risk or fall risk.© 2019 John Wiley & Sons Ltd.

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