risk assessment and referals

  • Risk assessment- health care practitioner (HCP) identifies client/ situational factors that increase the probability of outward outcome

characteristics of risk assessment:

  • continuous process

  • evidence-based

  • transparent and client-inclusive

  • helps effective clinical decision making+ carer planning

Why do we risk assess:

  • identify factors that may impact on mothers/ babies health

  • identify potential risks, support clinical decision making and inform effective care planning

Client-specific risk factors (intrinsic):

  • psycho-social

  • lifestyle

  • communication

Situational risk factors (extrinsic):

  • accountability to clieny/ employer/ NMC

  • clinical skills/ competencies/ training/ experience

  • communication skills- history taking/ client referral/ team working

  • access to advice/ support/ help specialists

  • time required for assessment and caregiving

  • environment and lack of privacy/ unsafe care environment/ lack of diagnostic facilities

5 stages of a risk aassessment

  • identify

  • analyse

  • plan

  • track

  • document

Clinical decision-making:

what is used to help make decisions

  • start with client needs+followed w structured clinical investigation and risk assessment by HCP

  • create a a care management plan

Barriers to effective decision-making:

  • stress

  • fatigue

  • noise

  • distractions

  • poor history taking

  • lack of evidence from guidelines

  • lack of equipment

  • poor teamwork

  • staff-to-client ratio

science hypothetico-deductive model- decision-making

stage 1-

  • observing aspects andcominge to a general conclusion

  • cue recognition- signs and symptoms

  • history taking

stage 2-

  • exploration

  • further dialogue with women

  • focusing questions on signs and symptoms

  • physical examination

stage 3-

  • taking all information gathered and weighing up results

  • coming to a final diagnosis

stage 4-

  • care plan

  • may involve further tests

  • evaluation of response to care

  • Continue to follow the patient's well-being and choices

art, intuitive-humanistic model- decision making:

  • sometimes make decisions based on current information and appropriate action

  • ‘gut feeling’

  • risk of model is clues and risk factors may be missed

  • usually focus on one part of care/ complex problem

Spur-of-the-moment-modle (emergency)- decision making:

  • follow hypothetical-detictive modle already taken place

  • deal with client specific situation

Bias:

  • errors of thinking can affect judgment/ decisions we make

  • trust and favor of information from automated source

  • may stop from acknowledging other information