Exploring Nursing Interventions for Frail Individuals in Primary Care: A Systematic Review

Abstract

Aim: To report nursing interventions addressing frailty in older adults within primary care settings. Background: There is a very limited literature corpus on nursing interventions in primary care directed to elderly and frail individuals. Introduction: Primary care nurses play a key role in providing better care to frail older adults. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studying the PubMed, Cochrane, Scopus, and JBI databases from September 2013 to August 2023. Two reviewers screened the studies, and three reviewers independently assessed the risk of bias. Results: Fourteen studies made the final cut. Three categories of interventions were identified: (i) assessments derived from Comprehensive Geriatric Assessments (CGA), such as fall prevention programmes, pain diagnostic evaluations, and assessments of social problems and sociodemographic characteristics, like gender and age; (ii) frailty diagnoses using NANDA terminology; and (iii) nursing care interventions at home and the relationship of trust. Discussion: Despite the fact that primary care is mainly reactive to the needs of frail elderly individuals, it is also important to be willing to collaborate with them on implementing preventive plans. In the same spirit, establishing a relationship of trust between the health professional and the older adults is a key factor when nursing interventions are carried out in the home of a frail individual. Frailty is a multidimensional concept that is not necessarily linked to age, as studies address frailty starting from the age of 60 and continuing up to 80. But, although frailty is not determined by age, it may be influenced by it. Conclusion and Implications for Nursing and Health Policies: There is no consensus on the starting age for frailty screening or on a single diagnostic tool to identify frailty. Nurses use standardised nursing language related to frailty, both to diagnose it and to implement person-centred care intervention plans. Healthcare policymakers, health organisations, and primary care nurses should consider the findings of this research to evaluate the inclusion of standardised tools to assess comprehensive frailty in older adults. In addition, it is also crucial to prioritise a relationship of trust between individuals and nurses to ensure adherence to nursing care plans.