Publication Date


Degree Awarded Date

December 15, 2023



Background: Frailty is a syndrome characterized by an increased burden of symptoms and higher susceptibility to adverse health, including higher functional decline rates, pressure ulcers, falls, delirium, extended hospital stay, and discharge to assisted living facilities. Screening patients for frailty before undergoing a surgical procedure is recommended to minimize postoperative complications. In the preoperative phase at a midwestern academic hospital, surgical patients are not screened for frailty using a validated screening tool.

Purpose: This project sought to calculate the Clinical Frailty Scale (CFS) score using a novel algorithm. After validating the novel algorithm, this research project predicted that clinicians would appropriately refer to the novel algorithm to identify frail patients. Other long-term goals included enhancing patient outcomes and influencing organization policies utilizing a frailty screening tool.

Theoretical/Conceptual Framework: The Johns Hopkins Nursing Evidence-Based Practice model was utilized to implement the frailty screening tool and evaluate its impact on frailty identification. The model uses a three-step process involving practice questions, evidence, and translation.

Method: This project utilized existing patient data from the patient’s Electronic Medical Record (EMR) and identified physical frailty using a novel algorithm developed by the research team. The CFS, a validated screening tool, was used to validate the novel algorithm’s ability to predict frailty.

Results: The correlation coefficient (r) between the novel algorithm and the CFS score from researcher #1 was 0.66835. The r value between the novel algorithm and the CFS score from researcher #2 was 0.637808. The r value of the CFS scores between researcher #1 and researcher # 2 was 0.8122. These findings suggest that the novel algorithm is a reliable tool for assessing frailty, and that there is agreement between the two researchers in their assessment of CFS.

Conclusion: In this project, the moderate positive relationship between the novel algorithm score and the CFS score suggest that the novel algorithm may be a useful tool for assessing the same construct as the CFS tool. However, further research is needed to determine the extent to which the novel algorithm and the CFS tool scores measure the same construct and whether one is more valid, reliable, or efficient than the other. Overall, the findings from this project suggests that the novel algorithm may have clinical significance as a potential alternative or complementary tool to the CFS tool for assessing the same construct.


English (en)

Document Type



Torres, Brian DNP, CRNA (Chair) Barnes Jewish College, Goldfarb School of Nursing

Associated Committee

Curtis, Mary PhD, ANP-BC, FNP-C, PHCNS-BC (Committee Member) Barnes Jewish College, Goldfarb School of Nursing

Gregory, Stephen MD (Mentor) Washington University School of Medicine in St. Louis

Included in

Nursing Commons