Risk assessment Flashcards
What is a risk assessment?
A process where information has been gathered, the level of risk identified, and a plan made to manage the identified risk.
What are the different categories of risk?
Suicide, Violence, Self-harm, Neglect, Vulnerability, Absconding, Substance misuse, and other risks
What is risk of suidide?
When a deliberate action is taken with the intent of ending ones life
How might psychosis and suicide overlap?
People who live with psychosis may hear voices compelling or commanding them to make a suidide attempt
What should be apart of a suicide assessment?
Asking about: Recent loss, lack of social supports (isolation), sense of helplessness/hopelessness, family hist of suicide, level of distress, mood, previous attempts, and access to the means of a plan
Is suicide risk higher in men or women?
Men
Is suicide risk higher for the older, middle age or younger population?
Younger and older
What is risk of violence?
When someone has previously caused harm to someone
What is a history of violence a strong indicator for?
Future risk (common in forensic settings)
How can the nurse assess violence?
Assessing the indivudals engagement with care, access to support systems, adherence to prescribed medications, substance misuse, level of arousal, and the ability to use coping strategies
How might psychosis overlap with the risk of violence?
People who live with psychosis may hear voices compelling or commanding them to act violently towards others
What is the risk of self-harm?
The action of causing physical harm to ones self without the motivation to end ones life (The means of regulating emotional distress)
What type of stressors influence the severity and frequency of self harm?
SITUATIONAL STRESSORS
How may psychosis overlap with the risk of self-harm?
People who live with psychosis may hear voices compelling or commanding them to self-harm
What substance greatly increases the risk of self-harm?
Alcohol
What is the risk of neglect?
This refers to a diminished capacity for someone to care for ones self
People who are depressed, paranoid, or have fewer support networks are at greater risk of what
Neglect
What age is neglect commonly noticed in?
With the older population but increasingly in the younger
How can the nurse assess neglect?
The patients mood, energy levels, and engagement with avaliable support networks
A previous neglect incident can potentially provide information about what?
Appropriate supports/interventions the patient needs
What is the risk of vulnerability (vicitimisation)?
Where people who live with a mental illness are more likely to fall victim to others rather than victimise others
What are some assessable factors for the risk of vulnerability?
Being homeless, substance use or addictors, being female, cognitive impairment, being arrested in the last 12 months, previous incidents, residing in a custodial setting or level of mood
What is the risk of absconding?
When a patient leaves the ward setting after an assessment has been made they they need to remain for safety reasons
What feelings/other risks is absconding related to?
The risk of self-harm, suicide, substance use, harm to others, feeings of disempowermend, or the need for a sense of secrurity
What is important to understanding when assessing the risk of absconding?
The motivation behind absconding
Can people be genetically vulnerable to substance use and addiction or is this a learnt habitt?
This can be a genetic vulnerability
What are some assessable risk factors for substance missue?
Health literacy, what the subtance is, how much is used, how frequently they use it, how they access it, and the cost of the substance
Why is it important to document of risk assessment findings?
Because our information is useless without documentation
What do we mean by ‘Historical factors/risk behaviours’ in a risk assessment?
This section is about making a timeline and identifying what has happened and when (4 stages)
What are the 4 stages of Historical factors/risk behaviours?
Immediate, Current, Recent, and Past
What is involved in the immediate stage of historical factors/risk behaviours?
At the time of the interview, this involves asking specific questions or observations to understand the here and now
What is involved in the current stage of hisotrical factors/risk behaviours?
The past 48 hours for the patient, this involves identifying what happened in the last two days and pulling information from this relating to assessing risk
What is involved in the recent stage of hisotrical factors/risk behaviours?
This is information from the last two months, this involves identifying what this person has done prior during this time relating to risk
What is involved in the past stage of hisotrical factors/risk behaviours?
Information from over two months ago, this involves refering to hisorical notes and asking the patient of previous risk behaviours from that time
What is involved in documenting clinical/internal factors?
Thinking what has internally driven this person to act in the manner that they did. Using the mental state examination and observations to document this
What is involved in situational factors?
Any external factors that influence risk such as social situations, relationship issues, legal issues, employment, finances, stressors, substance use and access to wepons or lethal means to carry out plans to harm self or others
What is formulation all about in the risk assessment?
This is where you pull all the information together and determine the level of risk for the patient (summary) . You need to make sure you prioritise the most important infromation at the beginning of the summary
