Development of framework for comprehensive assessment and management of nursing risks in older patients
WANG Mei
YUE Xiao
ZHOU Chenxi
YUAN Quan
ZHOU Rong
LI Wanling
Abstract：Objective:To construct a systematic comprehensive assessment and management framework for nursing risks of older patients,so as to optimize the assessment and management of nursing risks of older patients,improve the quality of nursing care,and ensure the safety of patients.Methods:Based on the scoping review and content analysis method,a systematic retrieval,screening and analysis of relevant domestic and foreign papers from 2014 to 2024 were carried out.The core categories related to nursing risks,preceding factors and subsequent factors were classified,coded,compared and integrated to determine the core nursing risk categories,preceding factors and subsequent factors of older patients.Combined with the discussion of the expert panel,the framework was finally constructed and improved.Results:A total of 21 478 papers were retrieved,and 346 core studies were finally included.The comprehensive assessment and management framework for nursing risks of older patients,namely Direct Risk Prevention and Control(SAFE)-daily nursing needs response(CARE)-systematic support(MAP),covers three categories of preceding factors(intrinsic factors,interaction factors,constraint factors),11 core nursing risk categories(SAFE skin injury,agitation/delirium,fall,embolism;CARE-catheter-related risk,nutritional risk,restraint,excretory risk;MAP-medication management risk,activity decline,transitional risk),and six categories of subsequent factors(deterioration of physical condition,negative psychological outcomes,loss of function and independence,decline in quality of life,care and resource pressure,increase in economic cost).Conclusions:The SAFE-CARE-MAP framework fully integrates the characteristics of older patients such as multiple co-existing diseases and superimposed risks.The established practical application path of SAFE-CARE-MAP is scientific and clinically applicable,which can help improve the quality of nursing care and patient safety in older patients.
Keywords：older adultsinpatientsnursing riskscomprehensive assessmentactivities of daily living
Publication Date：2025-07-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 2156-2164 )