1, Manuscript 2.DOI: 10.3912/OJIN.Vol20No01Man02 Key words: no keywordsSuicide is a preventable public health concern. As a practitioner I need to be aware of my viewpoint on risk both in my personal and professional life for this could impact on how I support service users. This reflects the significant role risk has come to occupy within services. Assessing and managing risk is an important skill within contemporary mental health nursing practice. Risk assessment for chemicals is a prerequisite prior to any risk prevention programme in general. Well conducted, it should lead to the construction of preventive actions plan which will find its rightful place in the Occupational Health Nurse’s ‘OHN’ project approach. The wellbeing of adults at risk of abuse or neglect is more important than. Whilst working with Mrs Croft, I completed a social care assessment, this holistic tool allowed me to explore possible risks in Mrs Croft’s life but also protective factors in her support network and lifestyle. Registered Data Controller No: Z1821391. Perform and document a suicide risk assessment/self-harm assessment. This highlights that the potential for risks associated with the experience of mental health problems are many and varied. The Five Main Steps in the Nursing Process. 10. Evaluation Of Care From The Health Care Professionals. This is not to deny the tragedy that each one of these statistics represents. Pawson, et al. 2 will provide some hints about the potential impact of this.). A desired outcome form has been developed from this process and our administration has uploaded the forms onto the system. I would conclude that it was a substantiated safeguarding incident and for the Care provider to make some major adjustments to the details of the daily reports. Tyrer and Steinberg (1998, p.92) state that ‘in assessments views and concerns are represented in problem definition, in prioritisation of needs to be addressed and in decision making.’. Ensuring the consistency of quality health care is important to health care practitioners and nurses, despite requiring different protocols to follow in every medical center. Mental Health Act and other legislation to safeguard people’s rights. As an organisation the local authority focuses more on analytical based risk assessments which are embedded in our social care assessment process. Assessment should include a complete history and evaluation of the delivery for potential risk factors. Details. [Type text] Template for a nursery risk assessment [Type text] What are the hazards? Every health professional has … How have others responded to them as a result of their use of services? From using a computer to handling hazardous goods or receiving a new piece of equipment, it’s essential that a risk assessment is carried out and counter measures are put in place to ensure the safety and wellbeing of everyone. Find your next job near you & 1-Click Apply! Meaning I have go to place I have never been that can be dangerous. Develop a safety plan in collaboration with the client (Appendix F). Risk assessment has been defined as an examination of the context and the details of past risk incidents in the light of current circumstances. The skills also require effective communication and observation of overt behaviour to evaluate whether all parties involved were in agreement The insights in this work are in the form of lessons learnt and thoughts on what can be done differently to improve the practice. Review the risk assessment tools that are used in your practice area. Log In or, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), To develop understanding of risk assessment, To identify skills and approaches to support effective risk assessment and management, To develop understanding of positive risk taking, To critically analyse risk in mental health practice, To identify opportunities to and participate in risk assessment in mental health practice. However with regard to Mrs Croft I feel that at present she falls within the category of those who could potential be exploited. Several assessments are included with the guidelines, models, databases, state-based RSL Tables, local contacts and framework documents used to perform these assessments. This, what steps are to be taken to assure their safety in future, the provision of any support, treatment or therapy including advocacy, any modifications needed in the way services are provided, how best to support the adult through any action they take to seek justice or redress. Alongside the risk factors there are also protective factors. Act upon and implement recommendations agreed in strategy meetings, improve communication within the organisation and other professionals. It has been highlighted that risk of violence and risk of suicide are important areas for the assessment of risk. In addition to demography, risk factors may include an intricate amalgam of psychological, social, biological, cultural, and environmental circumstances. What might be some of the potential risks of someone being in an in-patient environment with other people who are highly distressed? *You can also browse our support articles here >. Chapter 2 recognised that public perception of people with mental health problems is often lacking in understanding. Despite all the advantages captured in the conclusion, critical reflection fails to offer the means to observe and analyze work procedures (Taylor, 2010, p. 125). The MCA was designed as a protective factor for those with disabilities/cognitive impairments to allow them to make unwise decisions and if they lack capacity following assessment for decisions to be made in their best interest with due processes followed. From the very start of my work with Mrs Croft and her husband I have been aware of an emotional pull towards her case and situation. Chapter 2 recognised that public perception of people with mental health problems is often lacking in understanding. Falls are due to several factors, and a holistic approach to the individual and environment is important. Referrals from the clinicians to a social worker have the expectation of assessment using the social model. What are the short- or long-term side effects of this medication? This culminated in a situation where the government, media and sections of the public perceived care in the community had failed. Taylor says that practical reflection offers value in the form of insights that arise from increased awareness (Taylor, 2010, p. 124). Nach Director of nursing and risk management-Jobs in Chicago, IL mit Bewertungen und Gehältern suchen. The forum allows open discussion and the opportunity to share thoughts on the cases and plan future steps. Every health professional has a duty of care to patients. In order to understand this fully, it is important to consider the social and historical position of the concept of risk. Epstein refers to the Experiential and Analytical whereas Kahneman calls it System 1 (Thinking Fast) and System 2 (Thinking Slow). of this study was to compare tool performance in identifying women at risk for breast cancer. Whilst working with the Crofts it was very difficult to understand and gather their account of the risks and protective factors as they saw them. Maternity risk assessment form is a document this taken to review the workplace concerning the pregnancy or return to the new working mothers. Working with risk is a key feature of mental health policy (Department of Health (DH) 1999. Source for a new provider. This patch has demonstrated that there was an array of factors involved with the decision making process, some were conscious and some as a practitioner you only become aware of on reflection. What were the potential threats or dangers? One outcome might be the, development of an agreed plan of action for the adult which should be recorded on their care plan. This has been criticised as further perpetuating a stereotype linking violence with mental illness. These conditions and dementia have an impact upon memory, mobility which affects her ability to manage day to day tasks independently. Addenbrooke’s Cognitive Examination (or ACE) – Well validated assessment tool... Beck Depression Inventory (or BDI) . The presenting problems and the perceived risks in this case are malnutrition/hydration, risk of falls due to poor mobility and reluctance to use walking aids, muscle waste, further deterioration in cognition, physical health due to missed medication, risk of infections adult not supported with toilet needs and non-provision of adequate personal care and risk of self-neglect and social isolation, neglect and decline was apparent. Mrs Croft’s husband who is the main carer was present at the assesssment. Although I am passionate about injustice/abuse I do have the ability to weigh up what will work or not and when to ‘let go’ and try a different approach, or just accept reconciliation. This new development entailed reviewing the risk management plans taking into the consideration the notice period. The solicitor has been advocating on behalf of the adult by supporting the adults throughout the investigation, acting as a protective factor monitoring and supervising. Patient gender influences the type of interventions. Kolb’s Reflective Cycle (1974) allowed me to take consideration of Mrs Croft’s situation and promote protective factors and minimise risk. nursing assessments and risk assessments that includes primarily paper processes, with some digital in a few speciality areas. What might be some of the potential risks of someone being in an in-patient environment with other people who are highly distressed? Are they taking any medication? This process gives the practitioner the chance to share the risk with senior managers therefore not taking sole responsibility for decisions; this is often seen as a protective factor for the worker. Assessing and managing risk is an important skill within contemporary mental health nursing practice. NHS trade unions have published a summary of principles on health and safety risk assessment and vulnerable workers (including BME staff groups) during COVID-19.This includes principles relating to prevention measures, access to risk assessment, risk assessment process, and risk reduction measures.Tips and signposting to resources for both safety reps and staff side are included in the … As part of the risk management plan, it was identified that there was a need for change of accommodation to a circumstantial placement pending the outcome of the safeguarding investigation and in view of the notice served by the care provider. Other less restrictive options should be explored as soon as it is safe and appropriate to do so. I believe that I take calculated risks and do not shy away from what some may deem as risky behaviour if I am confident and comfortable with the decision. Often a management position, nurse risk … I recognise through experience in practice that hard evidence is more valuable when presenting an action plan/request to my manager. There was resistance from the Hospital Social Worker to place Mrs Croft in a circumstantial placement. Jon Glasby (2011, p.8) for example wrote about “risk and regulation in an era of personalisation”. Mr Croft has capacity in relation to deciding about provision of care and support. In this respect there are two key aspects of the risk assessment process: identifying the potential consequences (the actions) and the potential likelihood of those consequences. In order to further develop my skills with risk management I will take advantage of any training opportunities that arise, these are normally part of the adult safeguarding boards training programme and Learning Sets. What were the potential threats or dangers? As a matter of principle, the council must ensure that it does no further harm through its intervention. The manner in which the media reported such incidents has been identified as perpetuating a link between violence and mental illness (. However, there is potential for practitioners and services to work in a way that helps to reduce the potential for risk. Mrs Croft’s was visited when she was at her most responsive and gave her the best opportunity to answer questions put to her – this is in line with the Mental Capacity Act principles which exemplify anti-discriminatory and anti-oppressive practice. With regard to Mrs Croft’s case I found the complex case forum to be a positive experience it was good to share ideas with senior managers to ensure that as an organisation we all agreed on the direction that this case was taking. It entails the collection of information used to establish the likely occurrence of a future event and the impact and consequences of that event in terms of harms and benefits (Morgan 1998). Luhmann (1989; 1995) emphasised that emotions are often viewed as too personal and unstable to form part of our stable social institutions whereas Zinn (2008) states that emotions are a modesty advisor in decision making. Here are the steps that nurses follow to meet the needs of their patients. situation in a way that enhances involvement, choice and control as well as improving quality of life, Serious concerns relating to an adult who has care and support needs, is unable, to protect themselves because of those needs and who has been placed at risk of. Risk Assessment and Safety Planning for Nurses working in Mental Health Services. dominant value, and risk management is the cornerstone of nursing care. research evidence to support any intervention. The risk assessment was used to inform any interim protection plan to safeguard Mrs Croft. Risk Assessment and Safety Planning for Nurses working in Mental Health Services. In order to carry out a risk assessment for each significant hazard, decide if the risk is high, medium or low. I felt that I had acted professionally, that I had been very thorough, had gathered the necessary information, spoken to all appropriate parties and I had remained in charge of the investigation. Company Registration No: 4964706. The following risks were identified risk of malnutrition/dehydration, self-neglect, falls, risk of skin infections, further deterioration in in wellbeing. Clinical Risk Assessment - Clinical risk assessment is the process used to determine risk management priorities for patient care by evaluating and comparing the level of risk against organisational standards, predetermined target risk levels or other criteria. This may be developed into a question and answer discussion or reflective piece for your practice portfolio. Mrs Croft requires support with preparation of meals and drinks, personal hygiene, washing and dressing, administration of medications as she forgets to take her medication, supervision after toilet use to ensure she completes the tasks hygienically, support accessing the community and attending to her health appointments and monitoring of physical and mental health as condition is likely to progress. As I continue to develop into an experienced practitioner I hope to be able to confidently draw on various knowledge bases to ensure clear and positive decision making in relation to risk management and the planning process. I will be exploring the situation, the perceived risks and what action was taken to manage the risks. Only gold members can continue reading. In this instance Mr Croft was able to express that he wanted to remain empowered and in control of his life and as a result he now feels happy that his wife has appropriate support and in a place of safety. Following the advent of community care, people with mental health problems were more present within the community. In this respect there are two key aspects of the risk assessment process: identifying the potential consequences (the actions) and the potential likelihood of those consequences. However, it is important to critically explore where the culture of risk assessment and management in mental health arises from. The reflection adds great value to the practice of social work. Action by when? Relevance to clinical practice After you have made a list, try and identify what skills you used to assess what risks you identified. The A-G assessment is becoming a commonly used tool in primary and secondary care settings. Mrs Croft was initially referred to social services by her GP, who requested for social services intervention and support after her husband who is her main carer was incapacitated and hospitalised leaving Mrs Croft with no one to care and support her. Tools for Risk Assessment in Nursing - Return to Nursing Program 1. Any, involvement must be proportionate and reasonable, however the first priority must always be to ensure. I have also identified the need to continue utilising supervision and reflective practice as they both offer the chance to speak with other professionals about case work enhancing my knowledge and reflecting on my decisions. Avoid and identify the risk by doing a risk assessment. Hospital-based nursing faces difficult challenges from the vantage point of risk management. There are two types of risk assessment tools, actuarial and analytical/clinical based. The neighbours have volunteered to walk the dogs on a daily basis. The focus should be on improving their safety and wellbeing and supporting them to reach the, resolution that is right for them. It also identifies and uses some skills which may inform your approach to risk assessment in mental health practice. Thinking Fast/ Experiential refers to automatic responses where we use our intuition and it is effort free whereas Thinking Slow/Analytical is conscious thought with deductive reasoning, it is rational. Early sharing of information is key to providing effective help where there are emerging, concerns. For some mental health professionals the dominance of risk and concern with a perceived link between violence and mental illness has contributed to a culture of blame in mental health services. PDF; Size: 97 KB. The most common iatrogenic risks are the side effects and physical conditions, such as tardive dyskinesia, that may result from taking psychiatric medication. Careful assessment of pregnant patients helps identify postpartum hemorrhage risk. I have found with my work with Mrs Croft that I often have a feeling that can be explained as intuition. Here are the steps that nurses follow to meet the needs of their patients. Risk assessment and management should be based on the structured clinical judgement approach. You can add new rows and select the risk from your drop down menu, adding further information as required. I learnt that the application of skills can sometimes be subtle, and it takes critical reflection to identify such skills (Taylor, 2010, p. 95). I have presented Mrs Croft’s case at the complex case forum as a safeguarding was raised against the care provider and this case was complex as the case might end up as an organisational safeguarding in view of the fact that the care provider is involved in providing services to other vulnerable adults. Gaining the couple’s trust was vital for the professionals working with them, especially as we were all trying to gather their account of the risks they perceived in their lives. I recently undertook Virtual Dementia Training which has given me understanding and insight into the condition from a very practical viewpoint. any action to be taken in relation to the person or organisation that has caused the concern. It was imperative to ensure steps were taken to provide communication methods that ensured Mrs Croft is given every opportunity to actively participate in the process and if the mental capacity assessment identifies a lack of capacity, a referral is made for an independent advocate to promote anti-discriminatory and anti-oppressive practice which promotes choice and independence. Continues to integrate and prioritize all the information on an ongoing basis. I now understand that heuristics are at play with regard to my ability to make quick decisions when confronted with a complex or risky situation. Who might be harmed and how? Often, as service providers, we want to protect people from failure. Sep 6, 2017 - Explore Laurie Schweitzer's board "Nursing: Assessment", followed by 540 people on Pinterest. Milner and O’Bryne (2002, p.53 defined the exchange model as an empowering approach”. I recognise in myself that although I am not a risk taker I am most definitely not risk adverse. Nurses under pressure: do risk assessment tools help prevent pressure ulcers? Participates as a member of the interprofessional team in ongoing formulation of risk based on changing assessment data. It is in such instances that supervision becomes invaluable. Key risk factors. Nurses performing the assessment need to explain to the patient what they are going to do and seek their informed consent. This can contribute to defensive practice in which decisions are made based upon this fear and an avoidance of situations where people may be exposed to being able to take chances. They use this statistical information to make predictions in accordance with rules which are fixed (Buchanan 1999, Principles of contemporary mental health practice, Collaborative approach to nursing: assessment and care planning, Introduction to the nature and impact of mental health problems, Working with people to make choices about their treatment, Demonstrating leadership in a mental health setting, Placement Learning in Mental Health Nursing A guide for students. A number of ke… A falls risk assessment and a risk assessment for skin breakdown are two mechanisms that decrease liabilities and risks associated with the client and their condition. How the EPA conducts risk assessment to protect human health and the environment. There is a possibility this could bring the Local Authority into conflict with the care provider, perhaps putting the care provider’s reputation at risk. In an overview, a nurse risk management nurse’s job is specific to where she is employed. Risk assessment tools in mental health employ some actuarial measures. Action by who? A practitioner’s knowledge can encompass many things and can be created through many different avenues. Objective six within the Government document Valuing People (2001) stated that those with learning disabilities should have greater control and choice o;-=ver where and how they live, this objective was strongly felt in my work with Mrs Croft[, it is at the heart of community care and a principle that informs my decision making. People are not constant and therefore management plans must allow for review and reassessment. The risks are then assessed so that to see if they are harmful to the pregnant mother. When meeting with the GP to discuss the prospect of Mrs Croft’s returning home after examination and treatment he was very negative about the idea. harm because of the actions (deliberate or unintentional) of others. The GP did not consider Mrs Croft’s wishes and the psychological and emotional effect/impact of separation on both Mr and Mrs Croft. The use of service user and carer knowledge. The GP and other professionals wanted both adults to be permanently placed in residential care. A-G covers: airway, breathing, circulation, disability, exposure, further information (including family and friends) and … Practitioners fear that the consequences of their actions may result in a tragic event for which they are held to blame. Titterton (2005) noted that practitioners need to move on from risk assessing and talk more about management. I used this knowledge when I drew my best interest conclusion regarding the most suitable placement and accommodation for Mrs Croft.
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