Rapid Risk Assessment in Treating Patients with Intellectual Disabilities - Essay Example

? Rapid Risk Assessment in Acute Hospital for Patients with Intellectual Disabilities Research shows that patients with intellectual disabilities are usually at higher risks of premature death due to issues such as safety and poor quality health care. However, there is little research based evidence that supports this medical claim. Evidence is lacking mainly because adequate research has not been carried out on risk assessment in health care settings for patients with intellectual disabilities. The study focuses on an area that has been poorly explored, which is, approach in acute hospitals to risk assessment for patients with intellectual disabilities. Rapid Risk Assessment in Acute Hospital for Patients with Intellectual Disabilities Background to the Study Nurses that work with patients with intellectual disabilities are faced with various challenges. For instance, they are required to use evidence based practice while treating their patients. However, there is not adequate and clear research regarding evidence based practices for safety available to nurses. This brings up debates regarding practices that will ensure safety and quality care for people with intellectual disabilities. Nurses are required to check out current evidence based interventions that are suitable for treating these patients. Calls have also been made against using unfounded and pseudoscientific interventions to treat these patients. There is increased pressure on nurses to ensure their practices are based on sound evidence. Evidence based practice has gained influence as an approach to clinical decision making. As health care becomes more and more evidence based, nurses are required to be aware of the skills, resources and principles needed for evidence based practices (Kline et al., 2011). There are doubts regarding just how effective and applicable the results of evidence based treatments are to the general clinical application. Nurses continue to handle patients with complex life experiences and also those that have very severe intellectual disabilities. These stressful circumstances will undermine participation of treatment and can ultimately contribute to non-adherence to available treatment options (Read and Johnson, 2012). Advances in medical care ensure that life expectancy of individuals with intellectual disabilities approaches that of quite normal and healthy people. Severe intellectual disabilities are mostly accompanied by other medical conditions and physical disabilities. Health care needs of people with intellectual disabilities should, therefore, be met by mainstream health services. Highly skilled nurses are also required to work with these patients as they have a high intensity of health care support needs. Research conducted into this group of patients revealed some areas of concern. These areas include inadequate patient assessment as well as inadequate communication between nurse and patient. It is essential for nurses and patients to communicate effectively as this will help them understand their health needs and they will be able to prevent frequent admissions to hospital. Delivery of quality health care relies upon a series of interaction between a patient and clinician (Hart, 2010). Interaction will assist the clinician to make an accurate diagnosis and provide suitable treatment option. Each acute health care facility is required to conduct a proactive risk assessment using risk assessment tools. This provides avenues for identifying, reducing and prioritizing risks associated with patient safety. This enables clinicians to choose appropriate treatment options, therefore, reducing the chances of developing undesirable outcomes in patients. Health care is a high risk industry that is prone to serious errors. However, clinicians, through evidence based research, can reduce the chances of making medical errors. Commonly cited barriers to use of evidence based practices by clinicians include information overload, limited time, lack of research evidence as well as lack of skills for interpreting research results (Read and Johnson, 2012). Some of the methods outlined through which health care providers can choose suitable treatment options include making use of evidence based practices resources, negotiating protected work time to appraise research, seeking continued education as this will help develop skills and taking part in research evaluation interventions. Health care providers are also advised to establish journal clubs as they can provide supporting structures where one can find clinically relevant research. Also, clinicians should make contributions to evidence based clinical research guidelines. Ethical approval process The research article shows that safety risks for people with intellectual disabilities in health care settings are complex. Education and further research are required to underpin new tools for assessment for clinical practice. Treating patients with intellectual disabilities is a complex issue for nurses as there is little research in evidence based practices. This leaves the nurses to navigate a confusing path as they do not know how to choose the most suitable treatment option that will ensure patient safety and at the same time allow provision of high quality care. Health care field has made great strides in helping patients with intellectual disabilities. Health care providers should, therefore, ensure they administer appropriate treatment options to avoid worsening the condition. Patients with intellectual disabilities are at a higher risk of premature deaths within acute hospitals, especially if they are not provided with suitable treatment options. Nurses should ensure they provide this group of patients with safer and better care. This should be accompanied by a series of evidenced based actions to ensure safety and care need of these patients are fully met (Pearce and Ryan, 2008). Research Methodology and Methods A project structure was used to identify whether patients with intellectual disabilities are really at higher risks of premature death. The project structure, leading improvement in patient safety program (LIPS), was supported by the trust patient safety team. This program aimed to bring together current evidence available on patient safety. It also aimed to understand issues associated with patients with intellectual disabilities as well as develop a risk assessment tool that can be applied in care processes in health care settings. The project was designed to help build capability and capacity in acute hospitals. Discussion Evidence based practices enables nurses to develop quality practice guidelines that can be used to treat a patient, identify relevant information that can be shared with the patient as well as enables communication with the patient. Communication will enable a continuation of a self learning process which will lead to use of the best possible treatment for clients. Process of evidence based practice is essential for nurses. Differences in its application, however, arise due to the different practice domains and theoretical models. A framework for use in evidence based practice in treating patients with intellectual disabilities presents a process which follows a cycle that arises from decisions that have to be made in each stage of treatment. Questions which reflect information required to make decisions are developed. These questions also take into account specific client groups being treated, and also the context in which treatment takes place ((Read and Johnson, 2012). A crucial aspect of the evidence based practice process regards using the evidence with the patient. A critical appraisal is undertaken to determine its clinical usefulness and validity. Clinical reasoning is also used to find out whether the evidence fits features of the patient’s context such as occupation and environment. Values and preferences of the client are also considered. Evaluation of this process will also be undertaken to determine if improvement occurs in some outcomes. More research and data gathering is needed to provide nurses with new information. This is important as it helps resolve various clinical problems and provide suitable treatment solutions. Nurses also use various assessment processes to arrive at a diagnosis. Some of these processes include physical examination, history taking as well as standardized assessment tools. These processes enable in answering questions concerning diagnosis. However, these assessment processes should be used together with evidence based practices to ensure the best care is given to this group of patients. The best available evidence shows that successful treatment has to address various domains in a coordinated manner over a specified period of time. Careful clinical research documents the effectiveness of evidence based research in resolving challenges faced by nurses. Nurses who use evidence based approaches together with risk assessment tools record success in treating their patients (Dickerson, 2011). Many factors account for the success of this treatment approach. They include the patient, method of treatment applied, context as well as the relationship between a health care practitioner and his or her patient. Combination of these factors promotes effective treatment. An evidence based practice has positive implications in that it makes consistent and substantial contribution to patients’ success. This accounts for treatment options that will improve a patient’s condition. Nurses can also monitor patients’ responses to the ongoing treatments administered. Such monitoring will lead to increased opportunities that will enable nurses to modify technical strategies, improve the relationship as well as avoid premature termination before the patient gets well (Read and Johnson, 2012). Patients with intellectual disabilities may also have complex mental issues that affect functioning capabilities. This condition, therefore, requires compressive assessment that will encompass the patient, family, community as well as peers. Nurses should, therefore, carry out a critical examination to identify other conditions affecting a patient. This will be a worthwhile investment in money, time and health care resources in the long run. Some treatment options available for treating troubled patients seem not to be clinically suitable. This explains why nurses are faced with challenges when it comes to providing quality care and safety needs to their patients. However, there are various process analysis techniques that can be used to determine methods that can produce meaningful results for the health care industry. These analysis techniques are used to guide models and can also be used to point out safety problems and inadequacies. Before decisions are made, nurses have to consider associated risks, benefits, outcomes as well as costs (Marx and Slonim, 2003). Health care practitioners try to use evidence based practices that have been revolving in peer review literatures. A model is also built in which probabilities and relationships of various components are identified and then linked. Decision support models can alter inputs over a range to provide an analysis of the situation being reviewed. Key Findings and Recommendations The study concluded that nurses were more likely to use a short assessment in a familiar format. The study further concluded that risk assessment, without use of evidence based practice, does not ensure safe and better care is delivered to patients. Use of clear evidence based practices will ensure health care and total safety needs of patients are met. The developed risk assessment tool is used in various hospitals and it has improved the quality of health care patients receive. Its use ensures length of stay in hospitals is reduced and health care outcomes are improved. Patients with intellectual disabilities were at a higher risk of premature death due difficulty or delay in diagnosis, specialist referral or investigation. The study shows that there is a need for improved identification of patients with intellectual disabilities within hospitals as well as better implementation of reasonable adjustments as this will ensure they receive the care they need. Research also shows there is a lack of clarity regarding responsibilities of carers and professionals when a patient with an intellectual disability is admitted in an acute hospital. Limited protocols are in existence that outlines responsibilities within hospitals. Nurses are often in a dilemma and they have a different set of expectations. Nurses also have little realization of living circumstances of their patients outside the hospital settings. This usually leads to differences in the way treatment plans are delivered to patients. Work pressures within hospitals do not allow nurses to give adequate time to patients with intellectual disabilities. The study revealed that a large number of patients had poor experiences while receiving care in hospitals. There were also reports of some patients dying unnecessarily as a result of inappropriate treatment. The main explanations for these cases was that patients with intellectual disabilities are usually seen a slow priority. Many health care providers do not have a clear understanding about intellectual disabilities, and they also do not properly consult or involve families and carers of these patients. Nurses also rely inappropriately on their estimates about quality of life of a patient. Recommendations Health care professionals are required to involve the family or carers of the patient as they definitely have a vast experience of the needs of a patient. This will enable them have a clear identification of the needs of the patient before admission, and they will be able to avoid unnecessary procedures and sedations. It is also advisable for nurses to provide explanations to patients on what is happening using accessible communication aids (Van de Sande, et. al, 2011). Risk assessments should also be conducted as they help predict risks for patients with intellectual disabilities. A number of issues may arise for these patients when appropriate risk management and assessment tools are not used. Nurses who do not use structured risk assessment tools run the risk of making faulty assumptions or feeding into their own ideas regarding what treatment options may suit their patients. Also, by not using a structured risk assessment process, the clinician will decide risk indicators at an individual level. Obviously, this will have serious implications on the treatment of a patient (Flores, 2012). A significant reason for using continuous risk assessment on patients with intellectual disorders is that it can lead to far more accurate diagnosis and treatment of the condition. It can also lead to an effective targeting of support towards the patient. There has been a tendency within health care systems to be overly cautious when viewing risks in the absence of structured means of assessing the risk. Continuous risk assessment ensures treatment programs are targeted appropriately based on needs of a patient. It will also free up health care resources, therefore, ensuring provision of more intensive treatment programs and support to patients with intellectual disabilities (Forres, et. al, 2012). Research implications Research article shows there is need for more data gathering and research in order to provide nurses with more information regarding patient safety. A number of studies need to be carried out to ensure safety in health care facilities in order to reduce cases of premature deaths in patients with intellectual disabilities. Lack of adequate research places a heavy burden in social and medical outcomes and also poses threats to the safety of patients. Protecting patients from premature deaths is a fundamental aspect in providing quality treatment. There is a great need to apply current best evidence based practices and risk assessment tools in order to reduce patient falls. There are various studies that have been carried out to support changes in the practice of nursing. Research on prevention of premature deaths is greatly needed in health care sector to allow for an evidence based prevention program to be developed. Acute hospitals should also have a system in place that will ensure people with intellectual disabilities are identified correctly and that they are also provided with appropriate support (The Joint Commission Update for Infection Control, 2008). Implementation of an effective method of capturing numbers of patients who use hospital services will ensure a better understanding of issues. This will in turn reduce problems faced by the patients, nurses as well as their families. Evidence based practice needs to continue to encourage well performed research regarding suitability and effectiveness of treatment options for treating troubled clients. Benefits of evidence based practices lie integration of research and practice, improvement of patient care as well as informed decision making. All persons involved in health care need to have a consideration for best evidence in decision making process. This applies to clinicians, educators, policy makers or even managers. Understanding evidence based principles is relevant to all health care providers as health care sector evolves to become more evidence based. References Dickerson, P. (2011). Evaluating An Activity: Beyond The "Form". Journal of Continuing Education in Nursing.42: 292-293 Flores, E. K. (2012). Falls Risk Assessment and Modification. 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