The use of physical assessment skills by registered nurses in Australia: Issues for nursing education

School of Nursing and Midwifery, Learning and Teaching Education Research Centre, Central Queensland University, Noosa Campus, Queensland 4566, Australia.
Collegian Journal of the Royal College of Nursing Australia (Impact Factor: 1.18). 03/2013; 20(1):27-33. DOI: 10.1016/j.colegn.2012.02.004
Source: PubMed


The purpose of pre-service nursing education programs is to prepare competent graduates who are able to function as safe, professional registered nurses. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills. Previous research from North America suggests that the majority of skills taught to nurses in their pre-service programs are not used in practice. As part of a larger study, an online survey was used to explore use of 121 physical assessment skills by Australian nurses. Recruitment occurred via mailed invitation to members of the Australian Nursing Federation. Data were extracted from 1220 completed questionnaires returned by nurses who were mostly employed in New South Wales, were female and experienced nurses. Respondents indicated that they used only 34% of skills routinely. Results reinforce evidence found in the literature that many of the skills taught to nurses are either not used at all (35.5%) or are used rarely (31%). These findings have implications for the teaching of physical assessment skills in pre-service nursing programs, and raise questions about the value of extensive skills teaching in the context of contemporary health care. Further research into barriers to the use of physical assessment skills in nursing and the need for comprehensive skills preparation for the generalist nurse is likely to offer some solutions to these questions.

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    • "While universities strive to develop advanced competency-based curricula to prepare new nurses for practice, several studies evaluated the application of physical assessment skills in the real practice (Berkow et al. 2009). Some studies documented that nurses do not regularly use physical assessment skills (Barbarito et al. 1997, Secrest et al. 2005, Giddens 2006, 2007, Birks et al. 2013), or that they use only a small number of them (Giddens 2007, Birks et al. 2013), while baccalaureate nursing students usually perform less than half of the procedures taught in a physical assessment course (Barbarito et al. 1997). To our knowledge, however, no study evaluated the quality of physical assessment among a large sample of Italian nurses. "
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    ABSTRACT: Aims and objectivesThe aims of the study were to describe which of the core techniques of the physical assessment are regularly performed by a sample of Italian nurses, and to investigate the potential predictors of a more complete examination.Background Physical examination is among the essential tasks of nursing professionals, who are requested to perform a correct and complete physical assessment.DesignCross-sectional survey.Methods The study was performed between August 2013 and January 2014 in 17 Italian regions. A total of 1182 questionnaires were collected.ResultsMost participants were females (age range 41–50 years), and worked in Internal Medicine, Intensive Care and Surgical hospital units. Of the 30 core techniques that are currently taught and performed according to the Italian Baccalaureate degree requirements, 20 were routinely performed, 6 were seldom used and 4 were learnt but almost never performed (auscultation of lung, heart and bowel sounds and spine inspection). Graduate and postgraduate nurses, working in Intensive Care Units and Nursing Homes, were more prone than the others to carry out a more complete physical assessment.Conclusions The skills to perform a physical assessment are suboptimal among this sample of Italian nurses. Health and educational providers should pose more attention and efforts to provide nurses with an acceptable training in physical examination practice.Relevance to clinical practiceThis study describes the specific physical techniques performed by nurses in real practice and provides information on which skills require more attention in nursing educational programmes.
    Journal of Clinical Nursing 09/2015; DOI:10.1111/jocn.12997 · 1.26 Impact Factor
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    ABSTRACT: Health assessment skills are of the most important skills which nurses require. The more precise assessment, the better results would be obtained and the quality of patient care would be improved. However, in Iran, few studies have investigated nurses' assessment skills. This study was aimed to assessnurses' evaluation of the learned skills of health assessment and their use. This cross-sectional study was conducted on 200 nurses in Isfahan province hospitals. Data was collected by a questionnaire including demographic data and 120 health assessment skills. Nurses scored their frequency of using and proficiency in skills. Statistical analysis was conducted by ANOVA, Tukey test and independent sample T-tests. The highest level of using and proficiency in skills was related to taking history. Nurses received 87.25% of score in this field. The lowest level of application was in assessment of the urogenital system so that nurses received 16.37% of score in this area. Also the lowest proficiency was in assessment of the nervous system and nurses received 34.58% of score in this area. The level of nurses' proficiency in the health assessment skills was not satisfactory. Modifying the curriculum and cooperating of nurse managers and nursing schools can help to improve the situation.
    09/2013; 2(3):39-43. DOI:10.5812/nms.13316
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    ABSTRACT: AimTo develop and psychometrically test the Barriers to Nurses’ use of Physical Assessment Scale.Background There is growing evidence of failure to recognize hospitalized patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses’ use of physical assessment in the acute hospital setting and no validated scales have been published.DesignInstrument development study.Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care Registered Nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing.ResultsThe final scale was reduced to 38 items representing seven factors, together accounting for 57·7% of the variance: (1) reliance on others and technology; (2) lack of time and interruptions; (3) ward culture; (4) lack of confidence; (5) lack of nursing role models; (6) lack of influence on patient care; and (7) specialty area. Internal reliability ranged from 0·70–0·86.Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses’ use of Physical Assessment Scale and point to the importance of understanding the organizational determinants of nurses’ assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.
    Journal of Advanced Nursing 04/2014; 70(11). DOI:10.1111/jan.12408 · 1.74 Impact Factor
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