Clinical Nurse Risk Assessment Tool Analysis

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A clinical nurse specialist is often the individual consulted when organizations want to identify the best risk assessment tools to use in a clinical setting. Understanding how to determine which risk assessment tools are best for a specific organization or a specific patient population is not always clear. Often, the risk assessment tools used most often are selected because of a belief that if a tool was valid or useful in one population at one point in time, it will be valid and reliable in another population at another point in time. However, in health care, patient populations are rapidly changing; and a risk assessment tool that was useful five years ago, may no longer be useful today Aranda-Gallardo, et al. 2013). Thus, clinical nurse …show more content…

However, when selecting a risk assessment tool, it may be more appropriate to use different tools or at least different cutoff scores because of different characteristics in the groups being assessed. Further, a combination of methods or risk assessment tools may be best. For example, combining a risk assessment score with a nursing judgment score may be more accurate in identifying risk of an adverse event than either score alone. The validity of any risk assessment tool is not static and should be assessed for each population in which it will be used (Aranda-Gallardo, et al. 2013; Lalkhen & McCluskey, 2008). The only way to really determine the best risk assessment tool for a specific purpose and population is to test the tool or tools and calculate sensitivity, specificity, prevalence, and predictive values, so a decision can be made based upon current and relevant evidence, specific to the needs of the unit or organization. The purposes of this paper are to describe how to assess the validity of risk assessment tools using several easy-to-follow formulas and to demonstrate using calculations and methodology to compare risk assessment screening tools. Since some of the terminology may not be familiar, definitions are provided so the reader can refer to them while practicing the calculations (Textbox 1). [INSERT TEXTBOX …show more content…

Since the purpose of a risk assessment screening tool is to accurately predict the future development of some event or issue of interest to nurses and their patients, risk assessment (Parikh, Mathai, Parikh, Sekhar, & Thomas, 2008). For example, health care organizations may wish to predict who will fall, develop a pressure ulcer, or develop an infection so that preventive interventions can be implemented to minimize some negative event or issue during hospitalization. Since the validity of many risk assessment tools varies widely, it has been suggested that potential users should test the tool or compare tools prior to adoption. A valid risk assessment tool should accurately identify those at risk (high sensitivity) and those not at risk (high specificity). An ideal risk assessment tool would have 100% sensitivity and 100% specificity; but in most cases, higher sensitivity results in lower specificity and vice versa (Lalkhen & McCluskey, 2008). To determine the validity of a risk assessment tool or to compare two or more risk assessment tools, the clinical nurse specialist will need to calculate sensitivity, specificity, and predictive

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