Risk Instrument for Screening in the Community (RISC): Cross Cultural Perspectives

Leahy‐Warren, Patricia; Weathers, Elizabeth; Lupari, Marina; Campbell, Sadie; Clarnette, Roger; Orfila, Francesc; Fitzgerald, Christine; Paúl, Constança; O’Herlihy, Eileen; Cornally, Nicola; Ó’Caoimh, Rónán; Day, Mary Rose; Mulcahy, Helen; Molloy, William

doi:10.3844/ijrnsp.2015.42.50

Cited by 3 publications

(3 citation statements)

References 15 publications

(14 reference statements)

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“…The Risk Instrument for Screening in the Community (RISC) is a short (22), reliable (23,24), and valid, (25)(26)(27)(28)(29)(30) global risk-prediction screen, designed for use by community healthcare workers and was developed as part of Irelands' EIP on AHA three-star reference site, the COLLaboration on AGEing (COLLAGE) (see the Community Assessment of Risk and Treatment Strategies (CARTS) study at www.collageireland.eu) (31,32). The RISC identifies the presence and severity of concern across three domains (mental state, ADL and medical state), and scores the ability of an individuals' caregiver network to manage the patients' care needs.…”

Section: Measuring the Effect Of Carers On Patients' Risk Of Adverse Healthcare Outcomes Using The Caregiver Network Scorementioning

confidence: 99%

Measuring the Effect of Carers on Patients’ Risk of Adverse Healthcare Outcomes Using the Caregiver Network Score

Ó’Caoimh¹,

Cornally²,

Svendrovski³

et al. 2016

J Frailty Aging

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Background: Although caregivers are important in the management of frail, community-dwelling older adults, the influence of different caregiver network types on the risk of adverse healthcare outcomes is unknown. Objective: To examine the association between caregiver type and the caregiver network subtest of The Risk Instrument for Screening in the Community (RISC), a five point Likert scale scored from one (“can manage”) to five (“absent/liability”). To measure the association between caregiver network scores and the one-year incidence of institutionalisation, hospitalisation and death. Design: Observational cohort study. Setting and Participants: Community-dwelling adults, aged >65,attending health centres in Ireland,(n=779). Procedure and Measurements: The caregiver network subtest of the RISC was scored by public health nurses. Caregivers were grouped dichotomously into low-risk (score of one) or high-risk (scores two-five). Results: The majority of patients had a primary caregiver (582/779;75%), most often their child (200/582;34%). Caregiver network scores were highest, indicating greatest risk, when patients had no recognised primary caregiver and lowest when only a spouse or child was available. Despite this, patients with a caregiver were significantly more likely to be institutionalised than those where none was required or identified (11.5% versus 6.5%,p=0.047). The highest one-year incidence of adverse outcomes occurred when state provided care was the sole support; the lowest when private care was the sole support. Significantly more patients whose caregiver networks were scored high-risk required institutionalisation than low-risk networks; this association was strongest for perceived difficulty managing medical domain issues, odds ratio (OR) 3.87:(2.22-6.76). Only perceived difficulty managing ADL was significantly associated with death, OR 1.72:(1.06-2.79). There was no association between caregiver network scores and risk of hospitalisation. Conclusion: This study operationalizes a simple method to evaluate caregiver networks. Networks consisting of close family (spouse/children) and those reflecting greater socioeconomic privilege (private supports) were associated with lower incidence of adverse outcomes. Caregiver network scores better predicted institutionalisation than hospitalisation or death.

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Section: Measuring the Effect Of Carers On Patients' Risk Of Adverse Healthcare Outcomes Using The Caregiver Network Scorementioning

confidence: 99%

Measuring the Effect of Carers on Patients’ Risk of Adverse Healthcare Outcomes Using the Caregiver Network Score

Ó’Caoimh¹,

Cornally²,

Svendrovski³

et al. 2016

J Frailty Aging

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“…This study shows that the RISC compares favourably with the other short screens tested. Given that the median administration time of the RISC at <5 min (close to one minute when only the Likert scales are applied) is similar to and often shorter than the three frailty screens studied [ 27 ], and given that it is acceptable to a wide variety of healthcare professionals [ 28 ], it is reasonable to consider it favourably in selecting an instrument to correctly identify frailty in the ED [ 25 ]. However, the other clinimetric properties of the Overall RISC for detecting frailty were more modest.…”

Section: Discussionmentioning

confidence: 99%

“…The Risk Instrument for Screening in the Community ( RISC ) [ 27 ] is a short, subjective, global, acceptable [ 28 ], and reliable [ 29 ] risk-prediction instrument for use by healthcare professionals. The RISC quickly screens and stratifies patients according to their one-year risk of three adverse outcomes (institutionalisation, hospitalisation, and death) based on a healthcare professional’s subjective scores on a five-point Likert scale, scored from one (rare/minimal) to five (certain/extreme) based on the healthcare professional’s judgement taking into account available information.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Risk Instrument for Screening in the Community (RISC) among Older Adults in the Emergency Department

Ó’Caoimh

2023

IJERPH

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Although several short-risk-prediction instruments are used in the emergency department (ED), there remains insufficient evidence to guide healthcare professionals on their use. The Risk Instrument for Screening in the Community (RISC) is an established screen comprising three Likert scales examining the risk of three adverse outcomes among community-dwelling older adults at one-year: institutionalisation, hospitalisation, and death, which are scored from one (rare/minimal) to five (certain/extreme) and combined into an Overall RISC score. In the present study, the RISC was externally validated by comparing it with different frailty screens to predict risk of hospitalisation (30-day readmission), prolonged length of stay (LOS), one-year mortality, and institutionalisation among 193 consecutive patients aged ≥70 attending a large university hospital ED in Western Ireland, assessed for frailty, determined by comprehensive geriatric assessment. The median LOS was 8 ± 9 days; 20% were re-admitted <30 days; 13.5% were institutionalised; 17% had died; and 60% (116/193) were frail. Based on the area under the ROC curve scores (AUC), the Overall RISC score had the greatest diagnostic accuracy for predicting one-year mortality and institutionalisation: AUC 0.77 (95% CI: 0.68–0.87) and 0.73 (95% CI: 0.64–0.82), respectively. None of the instruments were accurate in predicting 30-day readmission (AUC all <0.70). The Overall RISC score had good accuracy for identifying frailty (AUC 0.84). These results indicate that the RISC is an accurate risk-prediction instrument and frailty measure in the ED.

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The inter-rater reliability of the Risk Instrument for Screening in the Community

Weathers

Ó’Caoimh

O’Sullivan

et al. 2016

Br J Community Nurs

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Risk Instrument for Screening in the Community (RISC): Cross Cultural Perspectives

Cited by 3 publications

References 15 publications

Measuring the Effect of Carers on Patients’ Risk of Adverse Healthcare Outcomes Using the Caregiver Network Score

Measuring the Effect of Carers on Patients’ Risk of Adverse Healthcare Outcomes Using the Caregiver Network Score

Validation of the Risk Instrument for Screening in the Community (RISC) among Older Adults in the Emergency Department

The inter-rater reliability of the Risk Instrument for Screening in the Community

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