Question

2.1) Aged care risk classification system

Answer 1

A risk is a potential incident or accident which may occur as a result of a hazard. Assessment of risk is about determining how likely and the impact of it when it happens.

Risk = severity of consequences x likelihood of occurrence

Many clinical risk assessment tools are used by nurses in their practice settings while caring, patients. Nursing defines the risk as a chance of the person getting hurt or doing dangerous to others. Risk assessment tools are used to measure levels of risk for certain situations, procedures and outcomes.

Risk management includes any institutional facility includes:

Security and fire risks

Occupational health and safety compliance risks

Equipment and system failure risks

Natural and manmade disaster risks

Industrial and employee relations risks

Risks of non-compliance

Accreditation risks

Financial and credit risks

Property damage risks

Adequacy of insurance risks

Common risks in aged care facility come from the unidentified or misidentified medical condition of residents.

They are:

Nutritional and fluid intake errors.

Improper handling of powerful psychotropic and other drugs, and mixed prescription use.

Inadequate fall protections.

Lack of proper care of skin integrity breaks.

Poor assessment of vision, hearing, sensation, and balance.

Poorly assessed dementia and cognitive impairments and failure to provide for them.

The idea of risk management is not new to the aged care industry, but there is little guidance available on risk classification system or on how to collect data to assess real risk or how to approach risk management systematically.

For the continuous quality improvement in aged care, there should be continuous risk management strategies.

The caregivers of the aged care facility must continuously ask and find an answer to the problems like :

What is wrong with the care provided?

What are the possible risks the residents face?

What can be done to prevent each risk?

How can it be managed if the risky event happens?

The first and foremost step of continuous risk management is systematic risk identification.

Using adequate tools assess the risk, priorities it, analyze the impact, Measures to prevent or manage them and incident reports if the risk happens.

The staffs of many aged care facilities are unaware of the criteria of risk management. Proper use of tools will help the risk management process.

Tools that can be used for risk management in aged care are:

1. Braden Scale is used to predict pressure sore risk.

The Braden Scale is a tool used for Predicting Pressure Ulcer Risk

It was developed in 1987 by Barbara Braden and Nancy Bergstrom.

The main aim of the scale is to help health professionals, especially nurses, assess a patient's risk of developing a pressure ulcer.

The parameters included in the Braden Scale are:

Sensory perception

Moisture

Activity

Mobility

Nutrition

Friction and Shear

The scoring with the Braden Scale

Every category except the 'friction and shear' is rated on a scale of 1 to 4and the later is rated on a 1-3 scale. The total possible score is 23 points. The higher the score the lower the chance of ulcer.

Very High Risk: Total Score 9 or less

High Risk: Total Score 10-12

Moderate Risk: Total Score 13-14

Mild Risk: Total Score 15-18

No Risk: Total Score 19-23

2. Falls Risk Assessment is used to predict the likelihood of a fall occurring.

The Falls Risk Assessment Tool (FRAT) was developed by the Peninsula HealthFalls Prevention Service in 1999. The assessment tool along with instructions for use competes it and it is a part of FRAT pack. It has 3 parts:

Part 1: Fall risk status (low, medium, high)

Part 2: Risk factor checklist

Part 3: the Action plan

It has a review part either.

References:

1. https://www2.health.vic.gov.au/about/publications/policiesandguidelines/falls-risk-assessment-tool

2.https://journals.lww.com/aswcjournal/Fulltext/2002/05000/How_and_Why_to_Do_Pressure_Ulcer_Risk_Assessment.8.aspx