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Nursing Teaching Exemplar: Risk Assessment
Introduction, patient issue, risk factors discussion, risk prevention, current practice issues, quality improvement issues.
In the treatment process, it is important not only to provide a correct diagnosis and to organize treatment. A significant step in the treatment process is to assess the possible risks that a patient can face. Risk assessment is one of the patient safety components together with reporting, safety culture, health information technology, and others (Agency for Healthcare Research and Quality, 2008). Risk assessment interventions can be helpful in the development of a care plan and are components of preventive strategies because any condition that is expected can be prevented or eliminated more efficiently.
One of the most important patient issues is safety. It is an integral component of patient well-being and general satisfaction with treatment quality. Safety statistics are worrying. Annual mortality in hospitals is up to 98,000 people (Center for Patient Safety, 2018). Also, adverse medication events are frequent and lead to injuries or deaths of more than 770,000 people. Thus, assessing risks to provide patient safety is a primary concern of healthcare providers.
Every disease has specific risk factors related to care and treatment peculiarities. Thus, for cardiovascular disease, such risk factors as race, sex, and age should be considered in the assessment (Goff at al., 2014). Some risk factors can be related to hospital treatment, such as pressure ulcers for example (Moore & Cowman, 2014). The others are connected with home health care or continuous treatment after discharge (Gershon et al., 2008). However, one of the significant risks in health care is the human factor. In this review, it will be presented as related to adverse events (Henriksen, Dayton, Keyes, Carayon, & Hughes, 2008). Human factors are among the constituents of the Adverse Events model (Henriksen et al., 2008).
Patient risk can be prevented in case it is properly assessed. The assessment provides implications for patient education which, in turn, allows to prevent negative patient outcomes. One of the possible ways to reduce the risk of adverse effects and medical errors is the use of technology in healthcare. For example, electronic health record keeps systematized patient information and can be useful for the elimination of human bias (Henriksen et al., 2008). Another risk prevention strategy is patient education that can reduce the risk of readmission after discharge.
In my current practice, evidence-based policies are used to prevent adverse events related to human factors. Efficient shift planning is used to prevent burnout and fatigue among nurses. Moreover, the use of electronic health records also contributes to the elimination of human factor risks and improves the quality of care thus providing patient safety.
In medical practice, particularly serious errors are known as ‘never events.’ They include wrong-site surgery, suicide, operation or post-operation complications, treatment delays, medical errors, and patient falls. Still, most of these events are preventable in case they were revealed by the risk assessment, and the measures were taken on time.
Quality of care is a primary concern of health care facilities. Constant quality improvement should become an objective of hospitals and other medical institutions. It is advisable to use the model for improvement that would include aim, measures, and the expected changes. To facilitate change in risk assessment, PDSA (plan, do, study, and act) cycles can be used. The model presupposes the repetition of cycles until the desired result is achieved. To assess the effect of improvement interventions, internal benchmarking can be used. It allows us to compare the risks before and after quality improvement interventions within a healthcare facility.
Agency for Healthcare Research and Quality. (2008). Advances in patient safety: New directions and alternative approaches (08-0034-CD ). Web.
Center for Patient Safety. (2018). Relevant facts and statistics. Web.
Gershon, R., Pogorzelska, M., Qureshi, K.A., Stone, P., Canton, A.N., Samar, S.M. … Sherman, M. (2008). Home health care patients and safety hazards in the home: Preliminary findings. In K. Henriksen, J.B. Battles, & M.A. Keyes (Eds.). Advances in patient safety: New directions and alternative approaches (pp. 1-16). Rockville, MD: Agency for Healthcare Research and Quality.
Goff, D., Lloyd-Jones, D., Bennett, G., Coady, S., D’Agostino, R., Gibbons, R. … Wilson, P.W. (2014). 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Journal of the American College of Cardiology, 63 (25), 2935-2959.
Henriksen, K., Dayton, E., Keyes, M.A., Carayon, P., & Hughes, R. (2008). Understanding adverse events: A human factors framework. In R.G. Huges (Ed.), Patient safety and quality: An ev0idence-based handbook for nurses (pp. 1-19). Rockville, MD: Agency for Healthcare Research and Quality.
Moore, Z., & Cowman, S. (2014). Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews . Web.
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