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Predictive validity of the BRASS index in screening patients with post-discharge problems. Blaylock Risk Assessment
P Mistiaen1, E Duijnhouwer, A Prins-Hoekstra
1Research Centre Primary-Secondary Health Care, VU Hospital, Amsterdam, The Netherlands. pmistiaen@algemeen.azl.nl
Journal of Advanced Nursing
|November 17, 1999
Summary
The Blaylock Risk Assessment Screening Score (BRASS) index effectively identifies elderly patients at risk for post-discharge issues, though its low sensitivity limits clinical use. Further development is needed for optimal discharge planning.
Area of Science:
- Nursing
- Gerontology
- Health Services Research
Background:
- Discharge planning is crucial for continuity of care in nursing.
- The Blaylock Risk Assessment Screening Score (BRASS) index aids in early identification of patients needing discharge planning.
Purpose of the Study:
- To evaluate the predictive validity of the BRASS index for identifying patients with post-discharge problems.
Main Methods:
- Prospective longitudinal study involving 503 elderly patients screened with the BRASS index at admission.
- Outcomes assessed via questionnaires at 7 and 30 days post-discharge for 226 patients.
- Utilized BRASS index, Problems after discharge Questionnaire, Nottingham Health Profile, and COOP/WONCA charts.
Main Results:
- High-risk patients identified by BRASS index often had longer stays and were not discharged home.
- BRASS scores significantly correlated with post-discharge difficulties across all domains.
- The BRASS index demonstrated low sensitivity but high specificity for predicting post-discharge problems.
Conclusions:
- The BRASS index is a valuable tool for predicting non-home discharge and correlating with post-discharge issues.
- Its high specificity is beneficial, but low sensitivity restricts widespread clinical application.
- Further refinement of the BRASS index is recommended for enhanced discharge planning.