To identify and focus on a specific risk to a patient. In order to do this effectively, a recognised risk assessment tool will be used and a treatment plan

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The purpose of this essay is to identify and focus on a specific risk to a patient. In order to do this effectively, a recognised risk assessment tool will be used and a treatment plan

then agreed upon. The efficacy of the assessment tool will be discussed along with the results it provides. Definitions will be offered throughout the assignment to assist the readers understanding of terms such as risk and risk assessment. An introduction to the patient and a brief description of the anatomy and physiology of the patient's condition will also be offered. The assignment will illustrate the use of a recognised nursing model along with the nursing process. Legal and ethical issues will also be discussed.

Before discussing any risk assessment tools it is first necessary to provide definitions for terms such as risk, risk assessment and risk factors. The Mosby Nurse's Pocket Dictionary defines the term risk as "a potential hazard" (2003, p303), this hazard could be caused by any number of risk factors. A risk factor could be described as anything, which may cause a person to be more vulnerable to complications (Churchill Livingstone's Dictionary of Nursing, 2002, p384). These could include injury, disease, compromised nutritional status or pressure damage.

Harrison (2003) describes risk assessment as "an assessment that can identify those at risk, so that steps can be taken to provide appropriate therapeutic treatment." Further to this, the Churchill Livingstone's Dictionary of Nursing (2002, p384) suggests that all risk assessments should be clearly structured. Therefore, an accurate assessment of a client's risk is vital in ensuring that the correct care plan is utilised to ensure the best possible outcome for the patient.

Risk assessment and management is an integral part of the nurse's role. The Royal College of Nursing's (RCN, 2002) definition of nursing reinforces the importance of using clinical judgement as a tool when providing care to assist people in maintaining or recovering health. It should also be used to help people to cope with any health problems and to ultimately help them to achieve the best possible quality of life.

The utilisation of a recognised framework is an integral part of assessing a patient in order to identify their needs. Roper et al. (2003, p4) provide a model for nursing based on the Activities of Living. This framework offers a clear structure for nurses to work around with a problem solving approach and also incorporates the nursing process. The Activities of Living framework covers 12 areas including maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and finally, dying. Assessment is the first stage of the Nursing process as identified by Yura and Walsh (1978) and cited by Holland et al. (2003, p.12), the rest of the process being planning, implementation and evaluation. Mallett and Dougherty (2003, p281) suggest that a thorough assessment focuses on the physical, psychological and psychosocial issues relating to a patient. This is necessary to enable identification of any risks and to then aid their prevention. Sharkey (1997, p49-50) suggests that it is of great importance for nurses to be able to make speedy identification of risks, as no situation is completely risk free. Whitfield (2000) cited by Stevenson (2004) found risk assessment, education and the formulation of protocols to be the most effective prevention strategies when focusing on the prevention of pressure damage. This would suggest that the ability to perform an accurate risk assessment is therefore an essential skill required by each member of the nursing profession. This interpretation is supported by Marks-Maran et al. (1988, p37).
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For the purpose of protecting anonymity and confidential information throughout this assignment, the patient will be referred to as Elsie so as to comply with Code of Professional Conduct (Nursing and Midwifery Council, 2002).

Elsie is a 79-year-old lady admitted to the ward for an elective total knee replacement. A total knee replacement is a surgical procedure, which replaces damaged or injured parts of the knee joint with artificial parts. To perform this procedure, the muscles and ligaments that surround the knee are separated in order to remove cartilage and bone from the ends of the thigh ...

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