dc.contributor.author | Osborne, S | |
dc.contributor.author | Douglas, C | |
dc.contributor.author | Reid, C | |
dc.contributor.author | Jones, L | |
dc.contributor.author | Gardner, G | |
dc.date.accessioned | 2017-07-25T12:31:17Z | |
dc.date.available | 2017-07-25T12:31:17Z | |
dc.date.issued | 2015 | |
dc.identifier.issn | 0020-7489 | |
dc.identifier.doi | 10.1016/j.ijnurstu.2015.01.014 | |
dc.identifier.uri | http://hdl.handle.net/10072/342178 | |
dc.description.abstract | Background: Registered nurses and midwives play an essential role in detecting patients at
risk of deterioration through ongoing assessment and action in response to changing
health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed
in hospitalised patients. While much attention has been paid to early warning and rapid
response systems, little research has examined factors related to physical assessment
skills.
Objectives: To determine a minimum data set of core skills used during nursing
assessment of hospitalised patients and identify nurse and workplace predictors of the
use of physical assessment to detect patient deterioration.
Design: The study used a single-centre, cross-sectional survey design.
Setting and participants: The study included 434 registered nurses and midwives (Grades
5–7) involved in clinical care of patients on acute care wards, including medicine, surgery,
oncology, mental health and maternity service areas, at a 929-bed tertiary referral
teaching hospital in Southeast Queensland, Australia.
Methods: We conducted a hospital-wide survey of registered nurses and midwives using
the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered
Nurses’ Use of Physical Assessment Scale. Median frequency for each physical assessment
skill was calculated to determine core skills. To explore predictors of core skill utilisation,
backward stepwise general linear modelling was conducted. Means and regression
coefficients are reported with 95% confidence intervals. A p value <.05 was considered
significant for all analyses.
Results: Core skills used by most nurses every time they worked included assessment of
temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental
status. Reliance on others and technology (F = 35.77, p < .001), lack of confidence (F = 5.52,
p = .02), work area (F = 3.79, p = .002), and clinical role (F = 44.24, p < .001) were significant
predictors of the extent of physical assessment skill use.
Conclusions: The increasing acuity of the acute care patient plausibly warrants more than
vital signs assessment; however, our study confirms nurses’ physical assessment core skill
set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue
comprehensive nursing assessment that could detect subtle changes in health status earlier
in the patient’s hospitalisation. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Elsevier | |
dc.relation.ispartofpagefrom | 951 | |
dc.relation.ispartofpageto | 962 | |
dc.relation.ispartofissue | 5 | |
dc.relation.ispartofjournal | International Journal of Nursing Studies | |
dc.relation.ispartofvolume | 52 | |
dc.subject.fieldofresearch | Nursing | |
dc.subject.fieldofresearch | Nursing not elsewhere classified | |
dc.subject.fieldofresearchcode | 4205 | |
dc.subject.fieldofresearchcode | 420599 | |
dc.title | The primacy of vital signs - Acute care nurses' and midwives' use of physical assessment skills: A cross sectional study | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Reid, Carol L. | |