Have youSCAND MMe Please?A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit

Abstract

The mnemonic Have you SCAND MMe Please? represents eight factors that contribute to preventable harms common in older hospitalised patients. This framework provides a model for harm prevention to assist nurses to implement comprehensive harm prevention to improve quality of care and safety for older hospitalised patients.

Standard risk assessment forms help reduce preventable harm in older adult inpatients: A retrospective chart review study

“…In the evaluation of skin integrity, for example, the three items were The data from the Australian hospitals was published previously (Redley & Baker, 2019). Access to the original datasets was obtained for this study.…”

“…After deriving cues from studies and guidelines for addressing the care of older adults in hospitals, an Australian study developed a framework of eight factors commonly associated with preventable harm in older adults and sensitive to nursing care quality (Redley & Raggatt, 2017 (Redley & Baker, 2019;Redley & Raggatt, 2017). This framework, which addresses common preventable harms in hospitalised older adults, was derived from guidelines for good practice for the care of hospitalised older adults.…”

“…Content validity for the framework was obtained using national standards from the Australian Commission on Safety and Quality in Health independently in the literature as nursing sensitive indicators of care quality, which the present study brings together in a novel single framework, rather than examining them independently as in most previous research. The framework has been used widely to examine nursing care in relation to the nursing process (assessment, problem identification, planning, intervention, and evaluation) on the basis of evidence-based nursing care to avoid common preventable harms in hospitalised older adults and undesirable patient outcomes due to new problems; it was also used successfully to examine nurses' documentation of harm prevention and to identify gaps in nurse documentation of assessments and interventions, thereby identifying hospital-acquired health problems sensitive to nursing care quality (McGrath et al, 2017;Redley & Baker, 2019;Redley & Raggatt, 2017). To date, this framework has not been used outside the Australian context.…”

Documenting patient risk and nursing interventions: record audit

“…The items in the purpose developed data extraction tool (Table 1) were derived from tools previously used to examine documentation of the nursing process and the nursing management of factors contributing to common preventable harms. 22,[28][29][30][31] Quality and completeness of documentation of the nursing process were defined by (1) the comprehensiveness of documentation to capture all four steps of the nursing process; (2) individualisation of care through the comprehensive documentation of patient risk assessment, planning, interventions and evaluation performed by nurses, and the inclusion of components expected for delivering holistic patient care such as the patient's social situation, coping, beliefs, information from significant others or hobbies. The items extracted from the clinical record are presented in Table 1.…”

“…Transparency of data capture was supported by field notes kept by the data extractors to provide an audit trail and ensure consistency during data extraction and analysis. Content validity of the data extraction tools was derived from previous validation reported in the literature, 22,[28][29][30][31] and face validity from review by three expert members of the research team. All nursing statements provide sufficient information for the reader to be sure about the care provided.…”