Frailty, Acute Brain Dysfunction, and Posthospitalization Disability Outcomes in Critically Ill Older Adults

Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

In this study, we enrolled 302 adults who were admitted to the ICU and assessed for pre-hospital frailty using the Clinical Frailty Scale (CFS), a judgment-based frailty assessment tool in which the patient is scored from 1-9: 1-3 is considered fit; 4 is considered vulnerable or very mildly frail; ≥ 5 is considered mild to severely frail; 9 is terminally ill. We assessed level of consciousness and delirium daily using the Richmond Agitation and Sedation Scale (RASS) and the Confusion Assessment Method-ICU (CAM-ICU) and defined acute brain dysfunction as the presence of delirium or persistent coma (RASS -4 or -5) over the first 14 days in ICU. Both frailty and acute brain dysfunction were associated with increased risk of severe physical disability or death at 6 months after hospital discharge and acute brain dysfunction was an important mediator of the effect of frailty on severe disability outcomes.

Objectives

Describe how to use the Clinical Frailty Scale to identify acutely ill adults living with frailty.
Identify the 4 features of delirium assessed by the Confusion Assessment Method for the Intensive Care Unit.
List 3 possible nursing interventions to use with hospitalized adults living with frailty to prevent functional decline after discharge.

Continuing Education Disclosure Statement

Criteria for Awarding Contact Hours

Learners must complete the entire activity and the associated evaluation AND read Implicit Bias impacts patient outcomes. No partial credit will be awarded.

Accreditation

American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for {contactHours} contact hours.

Disclosures

The Nurse Planner has determined that no individuals with the ability to control content of this activity have relevant relationships with ineligible companies.

Activities with pharmacotherapeutic credit are to assist the APRN in fulfilling their education requirements for licensure and certification renewals.

Refund Policy

Continuing Education Activities are nonrefundable.