title: Nurse-led implementation of the single assessment process in primary care: a descriptive feasibility study.
abstract: OBJECTIVE
  to determine the resources required to carry out the single assessment process in primary care.
  
  
  METHODS
  prospective descriptive study.
  
  
  METHODS
  one urban primary care practice, Southampton.
  
  
  METHODS
  nine hundred and forty-four people aged 70+ years, registered with the practice, not living in a residential/nursing home, or terminally ill.
  
  
  METHODS
  participants were sent the six-item Sherbrooke questionnaire (case-finding tool). Non-responders were re-mailed after 4 weeks. All those scoring 4, 5 or 6 and a randomly selected half of those scoring 2 or 3 were offered overview assessment and comprehensive assessment as indicated by the Minimum Data Set for Home Care protocol. The nurse assessor identified unmet needs and agreed an action plan with participants. Another researcher conducted semi-structured interviews with a purposive sample of 26 participants to elicit their views of the process.
  
  
  METHODS
  response rates/scores of Sherbrooke questionnaire; numbers/characteristics of people requiring overview and comprehensive assessments; nature of resulting recommendations/referrals and impact on other agencies; resources required; views of service users.
  
  
  RESULTS
  eight hundred and sixty-three (91%) participants replied. Five hundred and seven (54%) scored 2+, triggering an overview assessment, which was offered to 307. One hundred and twenty-four participants (40%) accepted; 64 (52%) had unmet needs (median 8 each, range 2-18), resulting in 34 referrals within the practice including four case conferences, and 21 to community/secondary health services. Few participants with a Sherbrooke score of 2 required comprehensive assessment. Users perceived the process as acceptable and useful, but not always relevant to their current needs.
  
  
  CONCLUSIONS
  targeting those scoring 3+ on the Sherbrooke questionnaire (28% of sample) may improve the identification of patients who would benefit from further assessment. A contact approach rather than a case-finding one may improve the relevance of this process to older people.
authors.affiliation: University of Southampton, Elderly Care Research Unit, University Department of Geriatric Medicine, Southampton, UK. hcr@soton.ac.uk
authors.forename: Helen C
authors.initials: HC
authors.lastname: Roberts
authors.forename: Zoe M
authors.initials: ZM
authors.lastname: Hemsley
authors.forename: Gwen
authors.initials: G
authors.lastname: Thomas
authors.forename: Philip
authors.initials: P
authors.lastname: Meakins
authors.forename: Jackie
authors.initials: J
authors.lastname: Powell
authors.forename: Judy
authors.initials: J
authors.lastname: Robison
authors.forename: Ian
authors.initials: I
authors.lastname: Gove
authors.forename: Gill
authors.initials: G
authors.lastname: Turner
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009730:Nursing Assessment; D011320:Primary Health Care; D011446:Prospective Studies; D012648:Self Care; D011795:Surveys and Questionnaires; D006113:United Kingdom