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		Utilización del Blaylock Risk Assessment Screening Score (BRASS) en la planificación del alta hospitalaria Filomena García Sánchez,1 Mª Luz Flores Antigüedad,2 Emilio Sánchez-Cantalejo,3,4,5 Julia Sánchez-Cantalejo3 1Distrito Sanitario Granada-Metropolitano, Unidad de Gestión Clínica Albaycín. Granada, España. 2Hospital Clínico San Cecilio, Complejo Hospitalario de Granada. Granada, España. 3Escuela Andaluza de Salud Pública. Granada, España. 4CIBER de Epidemiología y Salud Pública (CIBERESP). Madrid, España. 5Instituto de Investigación Biosanitaria de Granada. Granada, España Manuscrito recibido el 26.8.2016 Manuscrito aceptado el 12.11.2016 Tesela [Rev Tesela] 2017; 21
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García Sánchez, Filomena; Flores Antigëdad, Mª Luz; Sánchez-Cantalejo, Emilio; Sánchez-Cantalejo, Julia. Utilización del Blaylock Risk Assessment Screening Score (BRASS) en la planificación del alta hospitalaria. Tesela [Rev Tesela] 2017; 21. Disponible en <https://www.index-f.com/tesela/ts21/ts11125.php> Consultado el

Resumen Objetivo. Evaluar la utilización del BRASS como instrumento para planificación del alta hospitalaria (PAH) e identificar componentes asociados a la PAH en nuestro medio. Material y métodos. Estudio de casos y controles con 152 pacientes, 79 con PAH y 73 sin PAH. El ámbito de estudio fue el Área Sanitaria del Complejo Hospitalario de Granada. La información se obtuvo de la historia clínica, del informe de alta hospitalaria y de la valoración realizada por enfermera gestora de casos. Se midieron los componentes de la escala de BRASS y características sociodemográficas de los pacientes. Se utilizaron tablas de contingencia para análisis bivariante y regresión logística multivariante. Resultados. Categorizado el BRASS como 1-10, 11-20 y 21 o más, los pacientes con planificación al alta se distribuyeron así: 0%, 25.3% y 74.7%, mientras los que no tuvieron planificación fue 4.1%, 43.8% y 52.1%. Los componentes del BRASS que resultaron asociados a la PAH fueron el estado de agitación, de confusión, los trastornos visuales y auditivos y problemas de movilidad. Conclusiones. En nuestro medio no se siguen las recomendaciones de la utilización del índice BRASS como instrumento de PAH. Palabras clave: Blaylock Evaluación de Riesgo Evaluación de Riesgo/ Planificación de alta/ Enfermería/ Evaluación de Riesgo/ Rechazo de Paciente/ Rechazo hospitalario/ Índice de gravedad de enfermedad.		Abstract (Using Blaylock Screening Risk Assessment Score (BRASS) in hospital discharge planning) Aim. To evaluate the use of BRASS as instrument for hospital discharge planning and to identify items associated with discharge planning in our setting. Methods. A case-control study including 79 patients for whom discharge planning was conducted and 73 patients for whom it was not. Data was obtained from the medical history, the hospital discharge report and from the assessment completed by the nurse case manager. The setting of the study was the Health Area of Granada Hospital Complex. All items from the BRASS scale were measured, as well as socio-demographic characteristics of patients. Contingency tables were used for bivariate analyses and the multivariate logistic regression model.  Results. After categorising BRASS into three clases, 1-10, 11-20 and 21 or more, the distribution of patients who received discharge planning was: 0%, 25.3% y 74.7%, whilst those who did not: 4.1%, 43.8% y 52.1%. BRASS items found to be associated with discharge planning in our setting were: the presence of agitation, confusion, visual and hearing disorders, and mobility difficulties. Conclusions. Guidelines for the use of BRASS as an instrument for hospital discharge planning are not being followed in our setting. Key-words: Blaylock Risk Assessment Screening Score/ Discharge planning/ Nursing/ Risk assessment/ Patient discharge/ Hospital discharge/ Severity of illness index.
Bibliografía 1. Shepperd, S; Lannin, NA; Clemson, LM; McCluskey, A; Cameron, ID; Barras, SL. Discharge planning from hospital to home. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000313. DOI: 10.1002/ 14651858.CD000313. pub4. 2. Zwarenstein, M; Goldman, J; Reeves, S. Colaboración interprofesional: efectos de las intervenciones basadas en la práctica sobre la práctica profesional y los resultados de salud (Revision Cochrane traducida). En: Biblioteca Cochrane Plus 2009 Número 3. Oxford: Update Software Ltd. Disponible en: https://www.bibliotecacochrane.com. (Traducida de The Cochrane Library, 2009 Issue 3 Art no. CD000072. Chichester, UK: John Wiley & Sons, Ltd.). 3. Cunic, D; Lacombe, S; Mohajer, K; Grant, H; Wood, G. Can the Blaylock Risk Assessment Screening Score (BRASS) predict length of hospital stay and need for comprehensive discharge planning for patients following hip and knee replacement surgery? Predicting arthroplasty planning and stay using the BRASS. Can J Surg. 2014 Dec; 57(6):391-7. 4. Hakkarainen, TW; Arbabi, S; Willis, MM; Davidson, GH; Flum, DR. Outcomes of Patients Discharged to Skilled Nursing Facilities After Acute Care Hospitalizations. Ann Surg. 2016 Feb; 263(2):280-5. 5. Hunter, T; Nelson, JR; Birmingham, J. Preventing Readmissions Through Comprehensive Discharge Planning. Prof Case Manag. 2013 Mar-Apr;18(2):56-63; 6. Saint-Hubert, M; Schoevaerdts, D; Cornette, P; D'hoore, W; Boland, B; Swine, C. Predicting functional adverse outcomes in hospitalized Older patients: a systematic review of screening tools. J Nutr Health Aging. 2010 May;14(5):394-9 7. Mistiaen, P; Duijnhouwer, E;  Prins-Hoekstra, A;  Ros, W; Blaylock, A. Predictive validity of the BRASS index in screening patients with post-discharge problems. Blaylock Risk Assessment Screening Score. J. Adv. Nurs. 1999; 30:1050-1056 8. Dal Molin, A; Gatta, C; Derossi, V;  Guazzini,  A; et al. Hospital Discharge: Results From an Italian Multicenter Prospective Study Using Blaylock Risk Assessment Screening Score. Int J Nurs Knowl. 2014 Feb; 25(1):14-21. 9. Signorini, G; Dagani, J; Bulgari, V; Ferrari, C; de Girolamo, G. Moderate efficiency of clinicians' predictions decreased for blurred clinical conditions and benefits from the use of BRASS index. A longitudinal study on geriatric patients' outcomes. J Clin Epidemiol. 2016 Jan; 69:51-60. 10. Glare P. Predicting and communicating prognosis in palliative care. Prognostic tools can help, but should not be applied blindly. BMJ 2011; 343:6d5171. 11. Panella, L1, La Porta, F; Caselli, S; Marchisio, S; Tennant, A. Predicting the need for institutional care shortly after admission to rehabilitation: Rasch analysis and predictive validity of the BRASS Index. Eur J Phys Rehabil Med. 2012 Sep; 48(3):443-54. 12. García-Morillo, JS1; Bernabeu-Wittel, M; Ollero-Baturone, M; Aguilar-Guisad M; et al. Incidencia y características clínicas de los pacientes con pluripatología ingresados en una unidad de medicina interna. Med Clin (Barc). 2005; 125(1):5-9 13. Weiss, ME; Bobay, KL; Bahr, SJ; Costa, L; Hughes, RG; Holland, DE. A Model for Hospital Discharge Preparation: From Case Management to Care Transition. J Nurs Adm. 2015 Dec; 45(12):606-14. 14. Holland, DE; Knafl, GJ; Bowles, H. Targeting hospitalized patients for early discharge planning intervention. J Clin Nurs. 2013 Oct;22(19-20):2696-703 15. Moons, P; De Ridder, K; Geyskens, K; Sabbe, M; et al. Screening for risk of readmission of patients aged 65 years and above after discharge from the emergency department: predictive value of four instruments. Eur J Emerg Med. 2007 Dec; 14(6):315-23. 16. Saiani, L; Zanolin, ME; Dalponte, A; Palese, A; Viviani, D. Sensibility and specificity of   screening instrument for patients at risk of difficult discharge.  Assist Inferm Ric. 2008 Oct-Dec; 27(4):184-93. 17. Tappenden, P; Campbell, F; Rawdin, A; Wong, R; Kalita, N. The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review. Health Technol Assess. 2012; 16(20):1-72. 18. Crotty, M; Unroe, K; Cameron, ID; Miller, M; Ramirez, G; Couzner, L. Rehabilitation interventions for improving physical and psychosocial functioning after hip fracture in older people (Review). Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 19. Carpenter, CR; Shelton, E; Fowler, S; Suffoletto, B; et al. Risk factors and screening instruments to predict adverse outcomes for undifferentiated older emergency department patients: a systematic review and meta-analysis. Acad Emerg Med. 2015 Jan; 22(1):1-21. 20. Conroy, S; Dowsing, T. The ability of frailty to predict outcomes in older people attending an acute medical unit. Acute Med. 2013; 12(2):74-6. 21. Basic, D; Shanley, C. Frailty in an Older Inpatient Population: Using the Clinical Frailty Scale to Predict Patient Outcomes. J Aging Health. 2015 Jun; 27(4):670-85. 22. Kahlon, S; Pederson, J; Majumdar, SR; Belga, S; et al. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ August 11, 2015 187:799-804. 23. R Core Team (2015). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/. 24. Harrell, FE Jr (2015). rms: Regression Modeling Strategies. R package version 4.4-1. https://CRAN.R-project.org/package=rms. 25. Lakhan, P; Jones, M; Wilson, J; Gray, LC.  The Higher Care at Discharge Index (HCDI): Identifying older patients at risk of requiring a higher level of care at discharge. Arch Gerontol Geriatr. 2013 Sep-Oct;57(2):184-191 26. Panella, L; La Porta, F; Caselli, S; Marchisio, S; Tennant, A. Predicting the need for institutional care shortly after admission to rehabilitation: Rasch analysis and predictive validity of the BRASS Index.  Eur J Phys Med Rehabil 2012 Sep; 48 (3): 443-54.

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