Paramedic assessment of frailty: an exploratory study of perceptions of frailty assessment tools

Introduction:Frailty is recognised as a significant variable in the health of older adults. Earlyidentification by paramedics of those at risk of frailty may assist in timely entry toan appropriate clinical care pathway. Early referral to such pathways has beenshown to improve patient outcomes and quality of life, as well as delivereconomic benefits. To date, little research has been completed regardingassessment of frailty by paramedic professionals using validated assessmenttools. The objective of this study was to determine paramedicine students’perceptions of screening tools to facilitate assessment and knowledge of frailty ofolder adults. The Edmonton Frail Scale (EFS) and the Groningen Frailty Index(GFI) were determined suitable for this purpose.Methods:The research adopted a mixed methods approach using a survey tool developedto gather both qualitative and quantitative data from students at the completion ofa structured aged care clinical placement. Thematic analysis of the qualitativedata identified key features of the tools, while a Likert-type scale was used tomeasure perspectives about the suitability of the tools for use in paramedicpractice.Results:Thirty-seven paramedicine students were invited to participate in the study.Thirteen were able to use both tools to conduct frailty assessments andsubmitted survey responses. Student perspectives indicated both the EFS andGFI are potentially suitable for paramedicine and as clinical learning toolsregarding geriatric assessments. Mean time to administer the tools was 13.46minutes (SD 12.14) for the EFS and 12.19 (SD 9.6) minutes for the GFI.Conclusions:Paramedicine students support a frailty assessment tool to assist clinicaldecision making regarding older adults. Further appraisal of validated frailtyassessment tools by operational paramedics in a pre-hospital environment iswarranted to determine absolute utility for Australian paramedics