Deakin University
Browse

Use of standard risk screening and assessment forms to prevent harm to older people in Australian hospitals: A mixed methods study

Version 2 2024-06-04, 01:04
Version 1 2017-04-06, 12:28
journal contribution
posted on 2024-06-04, 01:04 authored by B Redley, M Raggatt
BACKGROUND: Standard risk screening and assessment forms are frequently used in strategies to prevent harm to older people in hospitals. Little is known about good practices for their use. OBJECTIVE: Scope the preventable harms addressed by standard forms used to screen and assess older people and how standard forms are operationalised in hospitals across Victoria, Australia. METHODS: Mixed methods study: (1) cross-sectional audit of the standard risk screening and assessment forms used to assess older people at 11 health services in 2015; (2) nine focus groups with a purposive sample of 69 participants at 9 health services. Descriptive analysis examined the number of items on forms, preventable harms assessed and sources of duplication. Qualitative thematic analysis of focus group data identified themes explaining issues commonly affecting how health services used the forms. RESULTS: 152 standard assessment forms from 11 Victorian health services included over 3700 items with 17% duplicated across multiple forms. Assessments of skin integrity and mobility loss (including falls) were consistently included in forms; however, nutrition, cognitive state, pain and medication risks were inconsistent; and continence, venous thromboembolism risk and hospital acquired infection from invasive devices were infrequent. Qualitative analyses revealed five themes explaining issues associated with current use of assessment forms: (1) comprehensive assessment of preventable harms; (2) burden on staff and the older person, (3) interprofessional collaboration, (4) flexibility to individualise care and (5) information management. Examples of good practice were identified. CONCLUSIONS: Current use of standard risk screening and assessment forms is associated with a high burden and gaps in assessment of several common preventable harms that can increase risk to older people in hospital. Improvement should focus on streamlining forms, increased guidance on interventions to prevent harm and facilitating front-line staff to manage complex decisions.

History

Journal

BMJ Quality and Safety

Volume

26

Pagination

704-713

Location

England

ISSN

2044-5415

eISSN

2044-5423

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2017, BMJ Publishing Group Limited

Issue

9

Publisher

BMJ PUBLISHING GROUP