Quality Health Care: Health Risk Assessment - Essay Example

Running Head: PROMOTING QUALITY HEALH CARE Quality Health Care; Health Risk Assessment Health can be said to be the operational and metabolic efficiency in living creatures. People have a duty to ensure they are experiencing proper health standards for their bodies. When the health of an individual is compromised, the result is always a myriad of complications that have far reaching physical, social as well as economic effects. Various research programs have been established with the purpose of providing important advisory into ensuring good health. However, human problems continue to rise with each passing day, hence more efficient risk assessment tools need to be used to ensure safety. A risk assessment tool is simply a structured concept or idea that can be used to detect any health issues in the body of a living creature. EPA (2012, p. 1-3) has released a report that checks into the effects of possible exposures throughout the stages of human development, stressing on the nature of phase of analysis. This report stresses on the effects of risks due to exposure to environmental hazards. It addresses the issue of how a child’s assessment of health risk can strengthen his overall health. ‘Health risk assessment is the process taken to estimate the nature and probability of adverse health effects in humans who may be exposed to chemicals in contaminated environmental media, now or in the future.’ (Human Health Risk Assessment 2012, p. 1). Many scholars have explained the need for prevention as opposed to curing. To this effect, we have a common saying goes; “Prevention is better that cure.” This is the reason behind the creation of an assessment tool. An effective assessment tool should be able to reveal any possible effects of harm that could be attacking your body. Having a bright future is many people’s wishes and desire. This is the reason why everyone welcomes a system that guarantees effective feedback when used to evaluate different health challenges. It is true that people have varying health needs that need special and thorough attention by resourceful persons and systems (Aras & Crowther 2010). In this case, we shall explore into the Braden’s risk assessment tool. Checking at its effectiveness in providing vital information necessary for detecting whether a person is budding a pressure ulcer on or inside her/his body. This tool has the main aim of helping assess patients or people that are at the most rick of getting pressure ulcers. It is able to tell the degree of risk which the person is experiencing (Braden& Bergstrom 1988, p. 1). “‘Braden’s assessment scale is made up of six subscales, which measure elements of risk that contribute to either higher intensity or duration of pressure, or lower tissue tolerance for pressure” (Braden Risk Assessment tool 2011 3). The scale has been used in many countries worldwide with great success. This scale comprises of six main sub-scales that are used in effective pressure ulcer assessment. i.e. Sensory perception Activity Mobility Skin moisture Nutritional intake Frictional shear (Cassell, 2010, p. 3) Just as noted earlier, the scale is used for one main objective; to determine without fault the people who are at risk of getting pressure ulcers. This is for the following reasons; to carefully plan for the necessary and effective management and treatment. Where a total score is detected, it reveals the strength of the intervention. Alternatively a patient having a subscale score helps health staff to introduce a pile of interventions that are deemed necessary. The scale has a table of values against which a patient’s health information is filed. It is important that the entire tool is filled and analysed so as to get a wholesome picture about the state of the patient. How does it work? The nurse or the person doing the testing needs to evaluate the condition of the patient in each of the categories. In doing so, he will have to allocate a number which will give the rating for the specific category. Once all the records have been assessed and carefully filled, the scores in the individual fields are added. This sum provides the final and overall rating, which may stretch from 6 to 23. The additions should be made with precision so that the actual status of the patient can be taken. How do you interpret the results? Usually where the scores are low, it means that there are chances that pressure ulcers are developing. The following rating helps us interpret the overall scores ;( Cassell, 2010, p. 3) At Risk (15-18) Moderate Risk (13-14) High Risk (10-12) Very High Risk (9 and below) In as much as the scale has been widely used with success, there a few challenges that are faced when using the scale. These are some of the reasons that make it not be 100% accurate. Those using the scale should always be careful so as to minimize margins of error. The best thing is that it can be used by anyone who can accurately interpret the figures. Inaccuracy is the tool’s main shortcoming; Inaccuracy usually arises because first, there is little or formal education and training available publicly about how to use and accurately make reliable scores in each of the sub scales. Likewise the errors are made by human during its use. The person administering the assessments may fail to accurately make correct computations which may lead to lower scores or higher scores that may not reflect the true status of the patient. When used by nurses, there is a high probability their application of clinical judgments in making the scores can bring about some marginal errors. This may therefore indicate that a certain case is severe, when it is not the actual picture. ‘Preventing pressure ulcers is an important phenomenon to paediatric nurses, pressure cells in this population represent a serious yet preventable iatrogenic injury’ Noonan C. et al (2011, p. 566-575). According to Noonan, there is a need for establishment of risk levels for various populations in order to know their risk of getting particular health conditions. If there are any programs that are designed to help alleviate this problem, then they should always aim at identifying those people who are risk free but with the chances of getting it. Noonan (2011), says, ‘the Braden Q Scale was developed in 1996.’ By having a Braden scale meant for predicting sore risks that are associated with pressure, this scale was made in identifying paediatric ulcer risk cases. According to Noonan (2011), the Braden scale tool can be used by anyone. It’s not a preserve of health workers only. During the assessment exercise, various methods can be used in the collection of data from patients. For instance, there can be interviews conducted among parents and their children in a case where the parent is examining his/her child. Charts can also serve as aids in the assessment exercise. This is where various charts that have information relevant to the assessment exercise are used. In addition, physical assessment can also be used, here various physical activities will be done by the patient, the performance outcomes fill in the table and thereby final computations can be made. The overall score of a person is used to tell whether the patient is at risk or is safe, with higher scores revealing the safety of the patient and lower scores showing higher chances of getting the pressure sores. According to Elizabeth et al (2001, p. 125-131), ‘Translated into many languages and used on every continent, the Braden Scale is known to have been created by Barbara Braden, PhD, RN, FAAN, and Nancy Bergstrom, PhD, RN, FAAN, in 1987.’ This tool of assessment has six main subscales which tackle two key etiological issues associated with PU development i.e; Pressure duration alongside its intensity Tolerance of the tissue to pressure A patient is exposed to clinical issues that incline him to powerful and extended pressure through mobility, various activities and matters of sensory perception. On the other hand nutrition with moisture inclines a client to powerful and extended pressure. When using the scale, there are descriptions for particular sub scales inside the table, which are filled in the course of assessment. This is why any literate person can comfortably handle it. After that, scores are made for final computations which then explain the condition of the patient. Using the tool in other areas apart from hospitals may not be so much helpful when it comes to interpreting the results; this is because medical interpretations are usually applied. This is because there are special circumstances that may make reading and interpretation of the scores difficult. For instance, suppose a patient has undergone a surgery exercise and assessment done immediately, the patient is likely to show lower scores. From the Braden’s scale, this will mean that the patient is at a high risk of getting the PU, while it may not be the real case. Bell (n.d, p. 5) explains that the reason for risk assessment is to assist nurses to get the potential of the patient who develop pressure ulcers. It is also useful in assessing the extent of the pressure damage that the patient is likely to have. Before its invention, nurses would find it difficult to tell whether a person was facing any open chances of getting the PU. It was equally impossible to satisfactorily give preventive interventions. Later in the 1960s the Braden tool was invented as the best aid to this effect. Bell (n.d) points that, “the foundation for this tool was based on a conceptual schema of etiological factors’ whereby ‘pressure’ and ‘tissue tolerance’ were identified as significant factors in pressure ulcer development”(6). This assessment has been used by many people. It has had its positive reviews while some have found challenges working it. This tool has been largely criticized because of failure of its users to effectively interpret the meaning of some of the parameters which the system recommends. An example is where the words ‘mobility and activity’ have been used to refer to risk factors. The issue here is that its authors employed the word ‘mobility,’ to mean movement, but an issue arises where they whether the patient is able or not to relieve pressure as a result of movement in his environment. Similarly, the word ‘parameter’ has been used to refer to occurrence and times of movement that a patient experiences. The truth is that as far as this scale is concerned, the two words have totally different meaning. For effective use of this tool, it then means that it has to be used only at the ward level. In all the three literature reports, it is evident that this assessment has been largely successful in many places (Curley 2003, p. 1). The few challenges that arise from the interpretation of results of the score are an issue that needs to be carefully rectified. So far, research has shown that the tool is being effectively used globally. The key question that remains is how effective public campaign can be done so that everybody adopts and uses it. The national Patient safety agency was established with the mandate to ensure that patients and the entire republic are able to access safety facilities. To this effect, they have continued to put across various systems that can assist in achieving this effect. This does not make them the chief overseers of this tool but rather they have a wider role of ensuring that people’s health status is well secured both in the present and future. Whenever a particular designed system gives overwhelming results, then they do recommend its adoption. It is perhaps this understanding that has made health assessment using the Braden’s tool gain prominence not only in the country but in other continents. Various stakeholders have received training on how to effectively implement patient systems. In order to ensure patient safety, there will always be new strategies created in order to curb new challenges in any systems of our society. Gower (2010, p.4) says that “Every time society faces a new problem or threat then a new legislative process of some sort is introduced which tries to protect it from future reoccurrence”. Health assessment is perhaps one new invention that is touted as a sure alternative to combating pressure ulcers. Its careful execution has been of great success, giving it universal acceptance. The fact that the Braden tool is effective brings out the question of whether it can apply in work places. It is common knowledge that many people are busy with national development issues. If there can be a program where people in work places can assess their health then it will improve the health checking of many people. Remember, health and safety is a mandate of every people in the country. The state is at its best to ensure that this is a national agenda and that it achieves its objectives for the best interests of the people. Most terminal diseases are usually managed when they are diagnosed earlier. It is not wise to resolve to treatment, something that would have been prevented with little or no finances. Pressure ulcers will be a thing of the past when we take t necessary recommendations to combat it. Since its effective, the Braden tool serves us right Conclusion It’s an important thing to realise that so far, using there is enough evidence to prove that using pressure assessment tools reduces chances of pressure ulcers. Of the many designed and tested systems, the Braden’s assessment tool gives the best option that balances two issues of sensitivity as well as specificity with proper estimates of risk. Considering the magnitude of the risks that are posed to people by developing PU, it is inevitable that everybody ought to take the necessary steps towards ensuring that he is safe. Through the many tested and accepted tools, People ought to do a good choice of the systems that they trust can give them desired results. Health departments will always be willing and ready to provide advisory and other kinds of assistance on this very subject. Information from these health care departments usually presents a clear picture about the general safety of people in the country. They always provide potential risks that are bound to affect the people and the necessary measures that need to be taken in order to remain safe. In the recent past, statistics collected have been helpful in enhancing the safety of people. Considering that the safety of patients is always a key issue, it’s important to take solid steps towards making the situation conducive. This safety mostly brings about various social effects to the respective families; economic issues are also felt by the families involved. Instead of having to use huge sums of money to treat the issues, people should be rational enough and take preventive remedies. Blackwell & Wiley (2003, p. 1-2) explains that reducing potential of risks is not just the duty of health care workers; it is the mandate of everybody. Just like the case with other industries, any system that is employed to improve efficiency does not lack shortcomings. It ‘shard to get a single fault-free system. The Braden tool for assessment should therefore be used without doubts since it has marginal points of errors. 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