The inter-rater reliability of the Risk Instrument for Screening in the Community.
Predicting risk of adverse healthcare outcomes is important to enable targeted delivery of interventions. The Risk Instrument for Screening in the Community (RISC), designed for use by public health nurses (PHNs), measures the 1-year risk of hospitalisation, institutionalisation and death in community-dwelling older adults according to a five-point global risk score: from low (score 1,2) to medium (3) to high (4,5). We examined the inter-rater reliability (IRR) of the RISC between student PHNs (n=32) and expert raters using six cases (two low, medium and high-risk), scored before and after RISC training. Correlations increased for each adverse outcome, statistically significantly for institutionalisation (r=0.72 to 0.80, p=0.04) and hospitalisation (r=0.51 to 0.71, p<0.01) but not death. Training improved accuracy for low-risk but not all high-risk cases. Overall, the RISC showed good IRR, which increased after RISC training. That reliability fell for some high-risk cases suggests that the training programme requires adjustment to improve IRR further.
Clinical Research Nurse, Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital and the Health Research Board Clinical Research Facility Galway, National University of Ireland, Galway City, Ireland.
Elizabeth
E
Weathers
Geriatrician, Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital and the Health Research Board Clinical Research Facility Galway, National University of Ireland, Galway City, Ireland.
Rónán
R
O'Caoimh
Research Support Officer, Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital.
Ronan
R
O'Sullivan
Institute of Biomedical Sciences Abel Salazar, University Of Porto, Portugal.
Constança
C
Paúl
Institute for Research Primary Healthcare, Jordi Gol University, Spain.
Frances
F
Orfilia
School of Medicine and Pharmacology, University of Western Australia.
Roger
R
Clarnette
Centre Manager, Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital.
Carol
C
Fitzgerald
UZIK Consulting Inc, Canada.
Anton
A
Svendrovski
Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital and the School of Nursing and Midwifery, University College Cork, Ireland.
Nicola
N
Cornally
Senior Lecturer, School of Nursing and Midwifery, University College Cork, Ireland.
Patricia
P
Leahy-Warren
Consultant Geriatrician, Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork City, Ireland.
D William
DW
Molloy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003152:Community Health Nursing / Q000193:education / Q000379:methods*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D064691:Nurses, Community Health / Q000523:psychology*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D006113:United Kingdom
Adverse outcomes; Frailty; Inter-rater reliability; Risk; Screening