Recent research highlights frailty as a significant predictor of functional decline and adverse health outcomes for individuals with chronic kidney disease. To address this, the Frailty Assessment for Care Planning Tool (FACT) was developed to evaluate frailty across crucial domains: mobility, function, social environment, and cognitive ability. This study explored the practical experiences of nurses utilizing the FACT tool within a specialized outpatient renal clinic, aiming to understand the impact of frailty screening in this context. The research sought to determine how the implementation of the FACT tool influenced provider perceptions of frailty and identify the key factors affecting the adoption and administration of this screening tool in a specialized clinical environment.
This qualitative study involved semi-structured interviews with five nurses from the Nova Scotia Health Authority, Central Zone Renal Clinic. Employing a grounded theory approach, the research team systematically analyzed the interview data to identify recurring themes and develop analytical models that reflected the nurses’ experiences.
The analysis revealed four core themes that encapsulate the nurses’ journey with the FACT tool. Initially, a sense of skepticism prevailed among the nurses, reflected in the theme “we were skeptical.” However, as they gained practical experience and proficiency in using the FACT tool, this initial hesitancy diminished, transitioning to a phase of “we made it work.” This progression was further characterized by active learning and adaptation, embodied in the theme “we learned how,” as nurses refined their approach to frailty screening. Ultimately, these experiences culminated in a deeper understanding of frailty, captured by the theme “we understand.” The study underscored that the successful integration of the FACT tool was facilitated by several key implementation factors. These included setting realistic implementation goals, providing clear and accessible guidelines for using the tool, and ensuring ongoing training and support for the nursing staff.
In conclusion, the nurse participants reported a broadly positive experience with employing the FACT tool for frailty screening. They indicated that using the tool significantly enhanced their comprehension of frailty’s multifaceted nature and subtle nuances. Moving forward, nurse-led initiatives focused on FACT screening should prioritize the incorporation of realistic goals, clear guidelines, and continuous training programs. Elevating the assessment of frailty to a prioritized aspect within clinical departments is crucial for ensuring the long-term sustainability and impact of frailty screening programs.
