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

Successful Completion

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

Accreditation

The 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

Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity. Activities with pharmacology hours are to assist the APRN in fulfilling the pharmacotherapeutic education requirements for licensure and certification renewals.

Activities meet the standards for most states that require mandatory continuing education for license and/or certification renewal. AACN recommends consulting with your own state board of nursing or credentialing organization before submitting your certificate of completion.

Refund Policy

Continuing Education Activities are nonrefundable.