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The big question: does healthcare rely too heavily on assessment tools and not enough on clinical judgement?


A recent study found pressure ulcers in intensive care patients may have been either over- or undertreated because a widely used tool may not be sensitive enough for critical care.

Reviewing the records of 7,790 ICU patients, researchers at the Ohio State University concluded the Braden scale was not accurate when it came to evaluating ICU patients.

 “The scale told us that every single patient in the ICU was at high risk for a pressure ulcer. But we knew that not every single patient went on to get an ulcer,” said Brenda Vermillion, a clinical nurse specialist who participated in the study.

Is there too much reliance on ticking boxes rather than clinical judgement?


Readers' comments (6)

  • Yes. Tools are tools not prophetic certainties. For guidance of the wise only.

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  • only as good as those using them!

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  • I remember someone saying that assessment tools are like a sat-nav – you still need to be able to drive. Sums it up nicely!

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  • Observation and communication are key to assessing patients

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  • Sarah Christie | 14-Apr-2014 5:30 pm

    excellent analogy. think of the number of people who have ended up in rivers or over a cliff!

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  • bob cat

    How about when clinical pathways are absolutely reliant on tools, and I'm thinking of the Wells score particularly?

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