Risk Screening: What is it?
Published: 05 October 2020
Published: 05 October 2020
It is important to differentiate risk screening from other similar processes including risk assessment and diagnostic testing.
Risk screening is the process of identifying clients who may be at risk of harm and then minimising any risks that have been recognised (ACSQHC 2018).
Unlike risk assessment, risk screening is a shorter and less complex process. Risk assessment may be performed after risk screening if deemed necessary (ACSQHC 2018).
It is also important to differentiate between risk screening and diagnostic testing. While diagnostic testing is performed in order to identify the cause of specific symptoms being experienced by the client, risk screening may be performed even if the client is feeling well in order to identify a risk of injury or disease, or a disease or injury in its early stages (IQWiG 2013; ACSQHC 2018).
Generally, risk screening is used as a starting point to determine whether any further or more detailed assessments would be beneficial for the client (VIC DoH 2015a).
Risk screening should be performed upon admission in order to establish a baseline for the client’s health. Ideally, it will then continue to be performed regularly and when required throughout the client’s care (VIC DoH 2015b).
The aim of risk screening is to:
This action aims to ensure that all clients receive initial risk screening upon presentation and that this is repeated when necessary (ACSQHC 2019b).
Health service organisations are required to:
There are a variety of cognitive, behavioural, mental and physical conditions, issues and risks that can be screened in healthcare, including (ACSQHC 2019b):
Risk screening may be conducted in several ways, depending on the client and the specific risk(s) being screened.
Medical tests may be used to screen for physical abnormalities, for example, a stool test to assess for the presence of blood. These tests are often unable to diagnose the client and require a follow-up assessment if abnormalities are detected (IQWiG 2013).
Short integrated screening tools generally comprise a series of closed questions for the client to answer. These tools are used to determine whether there are any risks or vulnerabilities that the client may be susceptible to. It is important to ensure any tools used have been validated for the client’s population (ACSQHC 2018).
Validated single risk assessment tools are used to assess whether the client is at risk of specific harm (e.g. falls and pressure injury). These are more detailed than short integrated screening tools (ACSQHC 2018).
Screening discussions involve initiating a purposeful, person-centred conversation with the client. Discussions can help you to determine the client’s baseline, as well as identify any potential risks. This approach may be useful for triaging clients to determine who requires further action and how immediately. Discussions can be initiated during other activities and assessments such as handover (ACSQHC 2018).
In order to ensure discussions are person-centred, it is important to:
The following table outlines some discussion areas to address with the client, along with the potential risks to assess for:
|Discussion area||Possible risks to assess for|
|Whether the client is an Aboriginal or Torres Strait Islander person||
|Reason for presentation to healthcare||
|Client’s current situation||
|Wellness prior to presentation||
|Client’s usual living arrangements||
|How far the client can walk||
|Client’s capacity to manage finances, bills etc. on their own||
|Nutritional intake and diet||
|Medications (how many, what they are and what they are used for)||
|History of alcohol, tobacco, recreational drugs, herbal and alternative medicines||
|Issues at home causing worry or concern||
|History of healthcare-associated infection (HAI)|
While risk screening can be a useful and valuable method of identifying potential risks, there are some issues and limitations that have been identified. It is important to keep these in mind when screening clients.
(IQWiG 2013; ACSQHC 2018)
Risk screening can be used to establish a client’s baseline health and identify any potential risk factors. However, it is important to be aware of the limitations to this process.
Note: This article is intended as a refresher and should not replace best-practice care. Always refer to your organisation's policy on risk screening.
Question 1 of 3
Ideally, when should risk screening be performed in healthcare settings?
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