RISK ASSESSMENT TOOL

The information published in this Guide is for general and educational purposes only. This Guide will not substitute any existing guidelines or is in no way meant to be a substitute. No action or inaction should be taken based solely on the information provided in this Guide. Our aim was to define a practical guidance for clinical practice to provide staff with some rationale addressing the individual patient requirements. Use this tool to factor an overall risk for a serious venous needle dislodgement.

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0$

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Step 2

0 POINT VERY LOW OR LOW

* The patient understands the implications of

VND and is sufficiently alert to take action if a

VND, or a problem that could lead to VND, occurs

Or

* A device that raises an alarm when a VND occurs

1 POINT MEDIUM

* The patient sleeps during dialysis, especially if

they are hard to wake up.

Or

* The patient has impairments that could affect

their ability to notice VND (such as lowered skin

sensitivity or poor eyesight) or has

communication difficulties.

2 POINTS HIGH

* There is more than one risk factor or

any of the risk factors are particularly severe

(e.g. patients going into deep a sleep)

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Step 1

0 POINT VERY LOW OR LOW

* The staff can observe the patient and easily access.

Or

* A device that raises an alarm when a VND occurs.

1 POINT MEDIUM

* There is a reduction in the number of staff able to make checks on the patients.

Or

* The staff are unable to access clearly due to the patient's location, covers, poor lightning etc.

2 POINTS HIGH

* There is more than one risk factor present


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Step 3

0 POINT VERY LOW OR LOW

* There is no suggestion that the patient´s

actions during dialysis will lead to VND.

1 POINT MEDIUM

* The patient suffers side effects (e.g.

hypotension, cramps, itching) that could lead to

unpredictable movement.

Or

* The patient is restless, not fully aware of being

on dialysis or know to tamper with the tapes

needles and/or lines.


2 POINTS HIGH

* Patients with more than one risk factor.

Or

* Patients who have had more than one

unexplained needle dislodgement should

score 2.

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Step 4

0 POINT VERY LOW OR LOW

* A standard taping protocol designed to

prevent VND is used.

1 POINT MEDIUM

* The taping technique does not include

measures to resist tugging on the needle tubing.

Or

* The taping has to be modified in a way that

makes it less secure (e.g. allergy, steep needle

angle etc).

2 POINTS HIGH

* Patients with more than one risk factor.

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Final score

Your final score is:


SCORE 0 - 2

*Continue with secure taping and maintain

awareness of VND

* No further actions is needed unless there is a

change in the patient´s condition or the

management of the unit.






SCORE 3 - 4

* Apply the EDTNA/ERCA recommendations to

minimize the risks.

* Ensure that taping technique is secure and

consider adding a documented check of taping

security after starting dialysis.

* If a patient is not fully aware of the risk of

VND, provide or reinforce education if possible.

* Make it as easy as possible to observe the

patient and their accessment.

* If appropiate, increase the frequency that staff

check the security of the needles.

* If appropiate, consider using a protective

device approved for detecting VND.






SCORE 5 - 8

* Apply the EDTNA/ERCA recommendations to

minimize the risks as described for medium risk.

* Consider use of a protective device approved

for detecting VND even if more frequent checks

can be carried out.




Summary

Description Information Points
Discount :
Total :