The inter-rater reliability of the Risk Instrument for Screening in the Community

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Weathers, Elizabeth
O'Caoimh, Rónán
O'Sullivan, Ronan
Paúl, Constança
Orfilia, Frances
Clarnette, Roger
Fitzgerald, Carol
Svendrovski, Anton
Cornally, Nicola
Leahy-Warren, Patricia
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Mark Allen Healthcare Ltd.
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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 one-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), medium (3) and 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 reduced for some high-risk cases suggests that the training programme requires adjustment to further improve IRR.
Screening , Frailty , Risk , Adverse outcomes , Inter-rater reliability
Weathers, E., O'Caoimh, R., O'Sullivan, R., Paúl, C., Orfilia, F., Clarnette, R., Fitzgerald, C., Svendrovski, A., Cornally, N., Leahy-Warren, P. and Molloy, D.W. (2016) 'The inter-rater reliability of the Risk Instrument for Screening in the Community', British Journal of Community Nursing, 21(9). pp. 469-475. doi:10.12968/bjcn.2016.21.9.469
© 2016, Mark Allen Publishing Ltd. This document is the Accepted Manuscript version of a Published Work that appeared in final form in the British Journal of Community Nursing, © Mark Allen Healthcare Ltd. To access the final edited and published work see