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dc.contributor.authorOsborne, S
dc.contributor.authorDouglas, C
dc.contributor.authorReid, C
dc.contributor.authorJones, L
dc.contributor.authorGardner, G
dc.date.accessioned2017-07-25T12:31:17Z
dc.date.available2017-07-25T12:31:17Z
dc.date.issued2015
dc.identifier.issn0020-7489
dc.identifier.doi10.1016/j.ijnurstu.2015.01.014
dc.identifier.urihttp://hdl.handle.net/10072/342178
dc.description.abstractBackground: 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.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofpagefrom951
dc.relation.ispartofpageto962
dc.relation.ispartofissue5
dc.relation.ispartofjournalInternational Journal of Nursing Studies
dc.relation.ispartofvolume52
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchNursing not elsewhere classified
dc.subject.fieldofresearchcode4205
dc.subject.fieldofresearchcode420599
dc.titleThe primacy of vital signs - Acute care nurses' and midwives' use of physical assessment skills: A cross sectional study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorReid, Carol L.


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