Integrated nursing risk assessment: Patient handling, falls, pressure ulcers, continence, dementia

This paper reports the development stages of an integrated adult inpatient risk assessment summary. The aim was to simplify the recording of assessment data and support communication of bedside information within the multidisciplinary team. It is part of a larger study using human factors/ergonomics (HFE) to manage the risk and associated injuries of in-patient falls. The previous documentation required staff to complete the appropriate sections of a 20 page adult admission risk assessment which was both complex and repetitious; thematic analysis identified that mobility and range of movement were recorded 17 times. Two workshops were held with subject matter experts (mobility, tissue viability, medication, falls) and medical ward staff. An iterative review process was used to identify, augment, reject and categorize themes and finally prioritize 7 topics for medical condition, confusion, mobility, fall history, skin condition, assistance needed to swallow/eat/drink and continence. There was also an alert box with information on allergies, infection control and communication (hearing and vision). The form was redesigned using HFE principles to support effective recording and transfer of information.