Facilitators and Barriers to Nurses Screening for Frailty in Acute Care in a Provincial Health Care System: A Survey Study Guided by the Theoretical Domains Framework

Abstract

Older adults living with frailty have increased healthcare needs, but require accurate identification for optimal care; nurses’ screening practice is unclear. This cross-sectional survey explored nurses’ frailty screening practices and barriers/facilitators in acute care. Descriptive statistics were generated from 5-point frequency and 101-point scales of frailty screening methods; practice areas were compared using linear regression. Means for barriers and facilitators were generated from a 43-item 6-point Likert-type Theoretical Domains Framework questionnaire. Respondents (n = 228) reported “usually” screening by clinical impression (median = 4, interquartile range = 4-5) and preferring it to formal frailty tools (M = 67.1, SD = 25.7). Practice area influenced general frailty screening (B = 0.81, r = .31, p < .001). The top barrier was belief conducting frailty screening was routine (M = 2.68, SD = 1.42, p > .05). Frailty screening tools supporting clinical judgement and embedded into routine have greater likelihood for uptake.