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Performing frequent client assessments

I’m a nurse on an in-patient mental health unit. We often receive orders from physicians asking us to perform checks on patients every 15 minutes due to a high risk of self-harm. These 15-minute checks are difficult for the nurses to perform because of our high workload and nurse-to-client ratios. What are our accountabilities for frequent assessment and monitoring? 

Performing ongoing client assessments is critical to providing safe client care. Assessment is a professional accountability and an essential part of your nursing practice, as outlined in Professional Standards, Revised 2002. 

All nurses are expected to regularly assess clients, although certain clients may require more frequent assessments, such as monitoring every 15 minutes. For example, if you work with clients who have acute mental illnesses, frequent checks may be ordered because there are unique safety issues. These include an increased risk of violence, self-harm and suicide. Many of these clients may be isolated, require restraints or have limited capacity for advocating for themselves. Therefore, frequent monitoring is essential in supporting client safety. 

Professional Standards states that nurses must facilitate, advocate and promote the best possible care for clients. Nurses must also take action if client safety and well-being are compromised. Therefore, if nurses have concerns about their ability to perform ongoing assessments as ordered and part of the client’s care plan, nurses are accountable for sharing those concerns with their team and clinical manager. 

All members of the health care team have a shared accountability to advocate for quality practice environments and support systems that promote safe care. Nurses are also accountable for providing a complete record of client care including documenting assessment data such as when client assessments are completed. For more information about these accountabilities, see the Documentation, Revised 2008 practice standard. 

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Page last reviewed August 21, 2018