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

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Clinical decision-making:

• 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

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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