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Clinical Risk Management in Mental Health

Mental health is the major illness that increases the disability of the individual concerning the wellbeing and thus it requires multidisciplinary or intersectoral care to improve the health of the patient. The health care setting should be framed in such a way to improve the quality of care that is required to improve patient health status (Mapangae et al., 2019). Many risk factors are associated with the acute mental health setting that not only increases the risk for the hospital setting environment but also increases the risk for the patient. The risk in the hospital setting needs to be reduced to improve the care procedure that is safe for the patient (Slemon et al., 2017). The risk assessment is important to identify the potential risk in the setting that needs to be addressed to improve the safety of the care that leads to quality of care which is important for the better patient outcome (Aven, 2016). The essay is going to discuss the different risk assessment method that can be utilized to identify the risk in the acute health care setting to improve risk management.

There are different types of risk assessment that are included in the setting to identify the risk that is important for the safe health care setting. The risk assessment includes qualitative risk assessment, quantitative risk assessment, site-specific risk assessment and dynamic risk assessment (Lele, 2012). 

One of the article presented by Tiusanen (2018) discussed that qualitative risk assessment is one of the most common risk assessment methods in the setting. It utilizes the assessor expertise and persona judgment method toward the health care setting. The qualitative risk assessment is directly involved to identify the different level of risk in the setting by considering the risk linked with the particular hazard. The qualitative risk assessments have three functions that include prioritising risk according to probability and impact, identify the main areas of risk exposure and improve understanding of project risk. It is preferred due to the interpretation of the easy results, quicker and simpler which increase the utility in the mental health setting. The study presented by Briner & Manser (2013) discussed that in the acute mental health setting the qualitative risk assessment is important to identify the different individual and care aspect that can act as a risk for any hazard. The qualitative risk assessment utilizes the qualitative data to identify the different aspect of the setting like individual behaviour, workforce clinical practise and organizational aspect. Some of the aspects that are considered in the clinical setting include treatment error, violent behaviour, violation of medical advice, technological error and staff action. 

Moreover, the study presented by Miller et al. (2017) state that quantitative risk assessment deals with the risk associated with the technology. The quantitative risk assessment includes the probability estimation concerning the various risk measure that involves organizational risk, departmental risk and individual risk. It numerical analyses the risk concerning the different factor that is associated with the mental health setting. Different techniques can be used for the quantitative risk assessment includes three-point estimate, decision tree analysis and expected monetary value. The objective of the quantitative risk assessment includes identifying the quantity and accessibility of the risk, identifying the risk concerning the different facilities and suggestive recommendation to decrease risk in the setting. The article presented by Rensburg & Wath (2020) discussed that in the quantitative risk assessment is performed by conducting the survey and interview with the clinicians, patient and management staff of the setting to understand their perceptive. The population perspective is important to identify risk as concerning the perspective of every individual in the mental health setting. The quantitative data is important to understand the intensity of the risk as per the clinical practice and management.

Another study presented by Li et al. (2016) discussed the importance of site-specific risk assessment in the setting to improve the risk analysis and management. The site-specific risk assessment evaluates a particular section of the setting to identify the specific risk concerning the particular section. The assessors of this risk assessment are considered to be specialist concerning the particular setting to understand the onsite feature that can lead to the risk in the acute mental health setting. They are considered to be important as they help to provide the best mitigation technique due to the specific risk assessment. The site-specific risk assessments require additional time and resources to complete the work thus it is preferred when specific results are required. The article presented by Kaya et al., (2018) site-specific assessment is important to identify the day to day process to identify the risk concerning the psychological and social factors. The site-specific risk assessment is important to focus on the specific factors concerning the risk. The site-specific risk assessment is important to identify the risk is patient-centric care in which all the incident have different specificity. 

The study presented by Villa et al. (2016) discussed the importance of dynamic risk assessment in the acute mental health setting. The dynamic risk assessment is helpful to take a quick decision concerning the safety of the population in the organization. The assessor should have good observing and analysing skills to identify and understand the risk concerning the setting. The dynamic risk assessment is important of the assessment as it considered the health, safety and wellbeing of all the individuals connected to the organization. The dynamic risk assessment is important to evaluate the procedure by understanding the balance between the risk and benefit to improvise the process accordingly. One of the important features of the dynamic risk assessment is that is helping to identify the risk flow that is important to correlate the different factors in the setting. The article presented by Penney et al. (2016) discussed that dynamic risk assessment is important in the mental care to identify the risk associated with assessment utilized for the intervention. The dynamic risk assessment is important in the acute mental health setting as it identifies the association of the dynamic item and concurrent effect over the patient that can lead to a hazard. The dynamic risk assessment helps to identify the causal effect of the different management aspect to improve the clinical practice by reducing the risk. 

The effectiveness of the qualitative risk assessment starts with their easy prioritizations that help the methodology to be moulded concerning the type of setting. Another effectiveness of the qualitative risk assessment is their easy implementations that help to improve the understanding concerning the risk factors that are associated with the setting. The accuracy can be evaluated as it utilizes the qualitative data that help to understand extensive data concerning the risk which is important for the risk management process. The qualitative risk assessment is also easy and cheap to conduct that improves its utilization in the care (Hordyk & Carruthers, 2018).

The effectiveness of the quantitative risk assessment can be estimated by its wide application and the use of numerical data. The objective method utilized in the quantitative risk assessment increase the accuracy of the results that is important for the identification of the risk which will improve the planning of the management. The data collected through the quantitative risk assessment help to identify the actual intensity of the risk that is important to identify the issue in the setting. Quantitative risk assessment effectiveness can also be understood by its ability to predict the probability to attain a specific objective concerning the risk mitigation. Quantitative risk assessment covers the broader perspective of the study that is important to improve the effectiveness of the assessment by improving the data collection important for risk assessment (Caster & Edwards, 2015).

The high effectiveness of the site-specific risk assessment due to its focus over the specific site thus it helps to improve the identification of the risk accurately concerning the scenario. The site-specific risk assessment also plays an important role in the immediate decision making concerning the risk or the management plan to improve the safe practice. It is considered to be the best method for planning the mitigation process thus it is preferred in the onsite risk assessment. The site-specific risk assessment helps to provide the situation centric results that are important to address the situation concerning the specific root cause and right mitigation technique to improve safety in the practice (Whittaker, 2015).

The effectiveness of the dynamic risk assessment is its quick action toward the risk assessment that is important to decrease the chances of hazard that is important for the safety of the population in the organization. It improves the workforce ability to identify the risk associated with the daily practice that improves their confidence by reducing the hazard and improving their self-efficacy. The accuracy of the dynamic risk assessment is due to its proactive approach concerning the risk assessment that improves the early identification of the risk. The dynamic risk assessment follows the stepwise manner for the risk assessment that improve the consideration of every aspect which lead to more accurate result concerning the prevalence of risk (Okoli et al., 2016).

The risk assessment can be improved by incorporating the specialist in the assessment team that will help to improve the identification of the risk concerning the acute mental health setting. The specialist can help to identify the actual problem rather than dispersing the issue. The article presented by Górny (2019) discussed that specialist in the risk assessment team is important to improve the early and right identification of the risk that is important to reduce the issue. Another aspect that can be improved is the workforce power and participation to utilize their skills to identify the potential risk in the surrounding. The study presented by Fenner-Crisp et al. (2016) discussed that workforce participation will help to improve their practices that are important to reduce the risk and they can also assist the risk assessment team is the identification process. The workforces are an important component in the risk assessment thus their empowerment is important to improve the process which will eventually improve the safety of the setting. The third aspect includes the strategic planning for the risk assessment process that is important to improve the assessments perceptive which eventually improve the identification of the risk. The study presented by Aven (2017) discussed that strategic planning is important to follow a set format for the identification process that reduce the chances of omission that can hamper the risk identification process. The strategic planning helps to identify the disruptive change that is directly responsible for the increased risk for the clinical practice. These three factors are important to improve the risk assessment process which is important to improve the quality of care by increasing the safety.

The essay can be concluded by adding that risk assessment is important aspects when it comes to mental health setting and the different risk assessment have their different method for risk identification. In the mental health setting, there are different factor like individual, workforce or organization that can increase the risk for the population this increase the need for the right risk assessment. The qualitative, quantitative, site-directed and dynamic risk assessment method can be utilized in the acute mental health setting concerning the situation of the setting and need of the organization. Different factors add effectiveness and accuracy to different risk assessment method but there is a need to utilize the risk assessment concerning the situation. Qualitative risk assessment is cost-effective one the other hand quantitative risk assessment is more accurate concerning the results. Site-directed risk assessment is important in situation-specific assessment moreover dynamic risk assessment is important for the quick risk identification. The risk assessment can be improved by various method but the three important aspects concerning the clinical setting include incorporating of specialist, workforce participation and strategic planning. These three methods improve the right implementation of the risk assessment in the care that is important for the early identification of the risk which will improve the safety and quality of care in the acute mental health setting.

References for Risk Assessment in Mental Health Settings

Aven, T. (2016). Risk assessment and risk management: Review of recent advances on their foundation. European Journal of Operational Research, 253(1), 1–13. DOI:10.1016/j.ejor.2015.12.023

Aven, T. (2017). Improving risk characterisations in practical situations by highlighting knowledge aspects, with applications to risk matrices. Reliability Engineering & System Safety, 167, 42–48. DOI: 10.1016/j.ress.2017.05.006 

Briner, M. & Manser, T. (2013). Clinical risk management in mental health: A qualitative study of main risks and related organizational management practices. BMC Health Services Research13(44), 1-11. DOI: 10.1186/1472-6963-13-44

Caster, O. & Edwards, I. R. (2015). Quantitative benefit-risk assessment of methylprednisolone in multiple sclerosis relapses. BMC Neurology, 15(206), 1-23. DOI: 10.1186/s12883-015-0450-x 

Fenner-Crisp, P. A. & Dellarco, V. L. (2016). Key elements for judging the quality of a risk assessment. Environmental Health Perspectives124(8), 1127–1135. DOI: 10.1289/ehp.1510483

Górny, A. (2019). Assessment and management of risk in improving the OHS management system. System Safety: Human - Technical Facility - Environment, 1(1), 105–111. DOI: 10.2478/czoto-2019-0013

Hordyk, A. R. & Carruthers, T. R. (2018). A quantitative evaluation of a qualitative risk assessment framework: Examining the assumptions and predictions of the Productivity Susceptibility Analysis (PSA). PloS One13(6). DOI: 10.1371/journal.pone.0198298

Kaya, G. K., Ward, J. R. & Clarkson, P. J. (2018). A framework to support risk assessment in hospitals. International Journal for Quality in Health Care. doi:10.1093/intqhc/mzy194 

Lele D. V. (2012). Risk assessment: A neglected tool for health, safety, and environment management. Indian Journal of Occupational and Environmental Medicine16(2), 57–58. DOI: 10.4103/0019-5278.107064

Li, F., Zhang, J., Yang, J., Liu, C. & Zeng, G. (2016). Site-specific risk assessment and integrated management decision-making: A case study of a typical heavy metal contaminated site, Middle China. Human and Ecological Risk Assessment: An International Journal, 22(5), 1224–1241. DOI:10.1080/10807039.2016.1151348 

Mapanga, W., Casteleijn, D., Ramiah, C., Odendaal, W., Metu, Z., Robertson, L. & Goudge, J. (2019). Strategies to strengthen the provision of mental health care at the primary care setting: An Evidence Map. PLOS ONE, 14(9), 1-15. DOI:10.1371/journal.pone.0222162 

Miller, J., Burton, K., Fund, J. & Self, A. (2017). Process review for development of quantitative risk analyses for transboundary animal disease to pathogen-free territories. BioResearch Open Access6(1), 133–140. DOI: 10.1089/biores.2016.0046

 Okoli, J., Watt, J., Weller, G. & Wong, W. B. L. (2016). The role of expertise in dynamic risk assessment: A reflection of the problem-solving strategies used by experienced fireground commanders. Risk Management, 18 (1), 4-25

Penney, S. R., Marshall, L. A. & Simpson, A. I. F. (2016). The assessment of dynamic risk among forensic psychiatric patients transitioning to the community. Law and Human Behavior, 40(4), 374–386. DOI:10.1037/lhb0000183 

Rensburg, E. J. & Wath, A. (2020). Risk assessment in mental health practice: An integrative review. Issues in Mental Health Nursing, 1–9. DOI:10.1080/01612840.2020.1756011 

Slemon, A., Jenkins, E. & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry24(4),1-10. DOI: 10.1111/nin.12199

Tiusanen, R. (2018). Qualitative risk analysis. Handbook of Safety Principles, 463–492. DOI:10.1002/9781119443070.ch21 

Villa, V., Paltrinieri, N., Khan, F. & Cozzani, V. (2016). Towards dynamic risk analysis: A review of the risk assessment approach and its limitations in the chemical process industry. Safety Science, 89, 77–93. DOI: 10.1016/j.ssci.2016.06.002 

Whittaker M. H. (2015). Risk assessment and alternatives assessment: Comparing two methodologies. Risk analysis: An official Publication of the Society for Risk Analysis35(12), 2129–2136. DOI: 10.1111/risa.12549

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