Optimizing Nursing Assessment of Bleeding Risk A Theoretical Comparative Analysis of the SH-BRAT and BAT Tools

Background: Accurate assessment of bleeding risk is essential to ensure patient safety, particularly in high-risk hospital departments. The ISTH-BAT (Bleeding Assessment Tool) has long been used to screen for inherited bleeding disorders; however, its applicability in acute nursing settings remains limited. The SH-BRAT (Selwan Hamza’s Bleeding Risk Assessment Tool) was recently developed as a nurse-led, context-specific tool designed to identify bleeding risk early during hospital admission. Aim: This study aimed to conduct a theoretical comparative analysis between the SH-BRAT and BAT tools regarding their structure, clinical applicability, and suitability for nursing use. Design: A narrative comparative design was utilized to critically evaluate the similarities and differences between the two tools. Setting: This study was conceptually conducted within the context of hospital-based nursing practice, drawing on evidence from literature, expert panel reviews, and tool validation data. Sample: No human subjects were involved in this theoretical analysis. However, the comparison incorporated expert evaluations from eight professionals who previously assessed the SH-BRAT tool during its validation phase. Tools of Data Collection: Data were gathered from a structured review of scientific literature and expert feedback previously collected during the content validation of SH-BRAT, alongside published data related to the BAT tool. Results: The SH-BRAT showed advantages in terms of speed, simplicity, and nursing integration, making it more suitable for frontline risk identification. In contrast, BAT remains a valuable diagnostic tool but requires specialized assessment and longer time for completion. The SH-BRAT’s binary scoring and structured format support rapid decision-making during patient admission. Conclusion: The SH-BRAT has strong potential for integration into clinical nursing practice. Its design supports early risk stratification by nurses and complements existing safety protocols in acute settings. Recommendations: It is recommended to conduct further reliability testing of the SH-BRAT and pilot its application in clinical environments such as oncology and surgical units. Integration into nursing education and protocols may enhance safety and improve patient outcomes.