History including Infection risk, Red flags, Assessment, Interventions, Diagnostics.

The framework encapsulates the cyclic nature of patient assessment, in which more than one element may be performed simultaneously. It also embraces the importance of reassessment and communication –  vital components of emergency nursing.  

• History (incl. Infection Risk): the process of collecting details about why the patient has presented and relevant background information about the patient. Infection Risk: nested within history, and refers to the patient’s risk of infection or suspected/confirmed communicable disease, including precautions required.
• Red Flags: historical or physiological indicators of urgency that identify potential or actual threat to life or limb, highlighting the need for timely escalation of care.
• Assessment: comprehensive physical examination, prioritised to ensure life threatening conditions are identified first, followed by focused assessment guided by the presenting problem.
• Interventions: the delivery of appropriate and prioritised interventions based on historical and physical assessment findings.
• Diagnostics: the ordering, performing and reviewing of further investigations including pathology and diagnostic imaging.

Other elements within the HIRAID^® framework:

• Reassess: The evaluation of care and monitoring of patient progress. Maintain a structured approach, repeat at appropriate intervals per condition of the patient.
• Communicate: Verbal/non-verbal skills necessary to effectively communicate with patients, families and clinicians. Use structured approach for clinical handover; graded assertiveness to escalate if needed; accurate and comprehensive clinical documentation.